The Latest

The Infosphere as a SDOH: Leveraging Providers’ Influence to Counter Vaccine Misinformation

By Luke Testa, Program Assistant, The Harvard Global Health Institute In 2018, a short video circulated on WhatsApp claiming that the MMR vaccine was designed by Indian Prime Minister Narendra Modi to stop the population growth of Muslims. Subsequently, hundreds of madrassas across western Uttar Pradesh refused to allow health departments to vaccinate their constituents.

Unemployment Insurance Can Help Reduce Food Insecurity, the More Generous the Better

By Cecille Joan Avila, policy analyst at Boston University School of Public Health. She tweets at @cecilleavila. Since the start of the COVID-19 pandemic in March 2020, more than 54 million Americans have lost jobs. Because of this loss in wages, two times as many Americans became susceptible to food insecurity, defined by the US

Texans’ Public Opinions on Social Determinants of Health

A first-ever Texas public opinion survey on social determinants of health (SDOH) has revealed that Texans largely agree on many issues regarding the significance of the impact of non-medical factors on human health. Recognizing the increasing awareness that social factors impact people’s well-being, the Episcopal Health Foundation (EHF) surveyed a representative sample of 1,200 adults

We know paid family leave saves infant lives — so when will policymakers catch up?

This post originally appeared on The Center for Health Journalism here. By Diana Montoya-Williams December 14, 2020 During a pandemic that has overwhelmed many intensive care units, those that serve our youngest infants have so far been spared from a surge of COVID-19 patients. This is in part due to the apparent low risk of mother-to-baby transmission of

Permanent Supportive Housing: An Effective Intervention for Chronically Homeless People

Homelessness is associated with high utilization of acute health care services. Among those who are homeless, a small proportion of individuals make up a large percentage of service use and likely face the most significant barriers to securing housing. For homelessness assistance services, engagement and retention in housing are critical priorities. New research from UC

A Survey of Racial and Ethnic Disparities in COVID-19 Outcomes at State, Tribal, and County Levels

This post originally appeared on The Incidental Economist here. Allison R. Kolbe, Ph.D. is an Oak Ridge Institute for Science and Engineering Fellow at the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Sean A. Klein, Ph.D. is a Presidential Management Fellow at the U.S. Department of

Moving Towards Equity: New Knowledge on Drivers of Health Webinar Series

On October 21st and 28th, authors from six articles featured in the Drivers of Health Health Services Research theme issue participated in a two-part webinar series to share key insights from their research. Authors discussed the significance of their findings as well as implications for social/health care system interventions. Key themes in the webinars included

How leading programs to address SDoH are pivoting in response to COVID – and what they’ve learned

By Alexandra Schweitzer The COVID pandemic changed the landscape of the social needs that drive health overnight. Millions of people lost their jobs; millions of people were ordered to stay home. People lost access to food for themselves and their families because they couldn’t afford it, or they couldn’t get to a grocery store. Miles

Want to Prevent Suicides? Understand Its Causes

By Farrokh Alemi, Professor of Informatics, George Mason University Suicide prevention is getting a bad rap. Many are frustrated by its lack of effectiveness. It seems effective in some countries and for males, but in the United States, flagship programs such as the Veteran Affairs Suicide Prevention program have been accompanied with increased suicides and

SDOH Research in Health Affairs

The February issue of Health Affairs featured many SDOH-related papers. Below we highlighted several of these that present evidence on the effectiveness of policies aimed at addressing health-related social needs and/or structural-level drivers of health. Read on for excerpts, and follow the links for the full read.

SDOH Roundup: Racism as a Driver of Health

We’ve talked about racism as a driver of health in previous posts; indeed, the toll of racism on BIPOC (Black, Indigenous, People of Color) bodies has gained increasing national attention in recent weeks, especially in light of the coronavirus, which exacts disproportionate economic and health tolls on racial minorities and immigrants, and police killings of

Social determinants, racism, and COVID-19

At an April 11 press conference, Surgeon General Jerome Adams acknowledged that people of color are disproportionately affected by COVID-19. For example, African Americans comprise 25% of the population of Milwaukee County, Wisconsin but nearly half of confirmed cases and three-quarters of the deaths. Latinos represent one-third of the population of New York City but

Social Determinants of Health in the News

Social determinants of health and health-related social needs are frequently featured in both popular news sources and academic publications. These excerpts from six recent stories caught our eye.

Racial bias in medicine

The response to drug epidemics cuts along lines of race and class. In my recent piece with Toni Monkovic in the New York Times’ Upshot Dr. M. Norman Oliver, Virginia’s health commissioner, said, “At the beginning, the opioid epidemic was centered in rural Appalachia, and as long as it involved poor rural whites, it did

Let’s Retire Myths About Individual Behavior and Health

This post, by Carmen Mitchell, originally appeared on The Incidental Economist. Carmen Mitchell is currently a fourth-year health policy doctoral student in the Department of Health Management and Systems Sciences at the University of Louisville School of Public Health and Information Sciences (SPHIS). She is currently affiliated with The Afya Project, an interdisciplinary research initiative

Healthy behavior matters. So are we responsible if we get sick?

This post, by William Gardner, originally appeared on The Incidental Economist. Dr. Gardner is a psychologist. He is the Senior Research Chair in Child and Adolescent Psychiatry at the Children’s Hospital of Eastern Ontario Research Institute, and Professor of Epidemiology at the University of Ottawa. He tweets at @Bill_Gardner.

The Price of Food Insecurity

The U.S. Department of Agriculture is considering cutting food stamps for 700,000 Americans, and while this change would supposedly save money in the short run, it could have untold costs in the long run. Research has shown that programs like SNAP and WIC are associated with better health and reduced spending on avoidable hospitalizations. Furthermore,

The Shifting Boundaries of Health Care

The following is an interview with Patrick Scott Romano, MD, MPH, FACP, FAAP, Professor of Internal Medicine and Pediatrics at UC Davis Health and C0-Editor in Chief of Health Services Research.

Driving Health Forward Across Communities

This is a guest post by Bechara Choucair, MD, the Senior Vice President and Chief Community Health Officer at Kaiser Foundation Health Plan, Inc. and Hospitals. He spoke on one of our panels in Cambridge and reflects on the meeting in this blog. 

Housing and Health: What Does the Literature Tell Us?

It is well documented that housing is closely associated with health. The location, condition, and context of where we live intersect many factors that indirectly affect health. Our housing literally encompass environmental (think: dust and exposure to the elements) and social factors (think: isolation and crime) that directly affect health. A person experiencing homelessness would

Education and Health: What Does the Literature Tell Us?

Across many disciplines, greater educational attainment is closely associated with health. People who have obtained more schooling are significantly likelier to live longer, healthier lives. The mediating pathways that facilitate this connection are myriad and complex. A number of pathways have been proposed, including ones involving health literacy and behaviors, employment opportunities, and social and

Getting under the hood of social determinants: Thoughts from the Cambridge meeting

In an illuminating set of conversations on Monday at the Drivers of Health event in Cambridge, a diverse group of experts discussed how health care providers, local policy makers and community groups can work together to provide everyone in society with “a fair and just opportunity to live their healthiest life possible,” as Julie Morita,

Addressing Symptoms and Root Causes

The following is an interview with Kathy Ko Chin, MS, President and CEO of the Asian & Pacific Islander American Health Forum, a national health justice organization which influences policy, mobilizes communities, and strengthens programs and organizations to improve the health of Asian Americans, Native Hawaiians, and Pacific Islanders. She’ll be speaking as a panelist

Moving to Opportunity

This post, by Harold Pollack, was originally published on September 22, 2012 on The Incidental Economist. It is reposted with permission here. Dr. Pollack is the Helen Ross Professor of Social Service Administration at the University of Chicago. Over the past decade, he has conducted diverse studies and intervention trials to improve services to vulnerable

Addressing SDOH in North Carolina

The following is an interview with Betsey Tilson, MD, MPH, Director and Chief Medical Officer for the North Carolina Department of Health and Human Services. She’ll be speaking as a panelist at our Cambridge meeting on December 2.

Why aren’t facts enough?

It seems intuitive that providing people with accurate health information will help them make better health decisions. But just providing information backed by research isn’t enough to change minds, let alone behavior.

The Value of our Health Care Dollars

The following is an interview with Daniel Polsky, PhD, MPP, Distinguished Professor of Health Economics at the Bloomberg School of Public Health at Johns Hopkins University.

Health as the means, not the end

The following is an interview with Sandro Galea, PhD, physician, epidemiologist, author, and dean and Robert A. Knox Professor at Boston University School of Public Health.

Which Health Policies Work?

Considering how much money we spend on health care in the U.S., we might hope that we allocate a good chunk of it toward evaluating the impact of the health policies we have in place. Unfortunately, this is rarely the case.

Social determinants of health in the news

Social determinants of health comes up from time to time in health policy news or as the subject of reports from health policy-focused organizations. Here are quotes from four stories or reports that caught my eye recently.

Debriefing on Detroit

The Drivers of Health meeting in Detroit on September 11 focused on the research and research gaps in the connection between health and housing (presented by Roshanak Mehdipanah of the University of Michigan) and education (presented by Adriana Lleras-Muney of UCLA). The meeting wrapped up with a panel discussion including those two scholars and Robert

Plant-Based Diets and Mortality

In one of his recent Health Care Triage videos, Aaron Carroll calls attention to a recent study published in the Journal of the American Heart Association that supposedly tells us something new about plant-based diets and health.

From the Urban Institute: What Would it Take to Reduce Inequities in Healthy Life Expectancy?

The Urban Institute recently published a report titled “What Would it Take to Reduce Inequities in Healthy Life Expectancy?” Its purpose is to articulate strategies to boost the effectiveness of the health system in addressing health-related social needs to narrow health inequities and areas of research that would help it do so. But it also

Connecting the Dots

One of the goals of Drivers of Health project is to engage diverse audiences in learning about what affects our health. But how do you get people interested? We thought an interactive might help, so we made one.

When black patients see non-black doctors

African American men live about 4.6 fewer years than non-Hispanic white men. There are many causes contributing to the difference, including a learned mistrust of the health system by African Americans. Another set of potential factors arises when non-black physicians treat black men. According to a study published earlier this year, that care just isn’t

The Proximal/Distal Paradigm

Factors that affect health are often described as either “proximal” (downstream or directly affecting health) or “distal” (upstream or indirectly affecting health). For example, income is thought of as distal (upstream) because it doesn’t directly affect health.

The legacy of the Tuskegee study

In the United States, African American men have the worst health outcomes of any major demographic group. At age 45, their life expectancy is more than three years less than that of non-Hispanic Caucasian men and more than five years less than African American women.

What is known about drivers of health: a literature review

While there is widespread understanding that the health system and other factors — social determinants — affect health, we know relatively little about their precise contributions to health differences across a population at a point in time or differences in health of a fixed population over time.

Allocating health outcomes to risk factors, part 3

A common way to assess how much various factors contribute to health is to estimate how much variation in health across the country is explained by each of those factors. But explaining variation is not as useful as many may think.

Allocating health outcomes to risk factors, part 2

I wrote about Nancy Krieger’s insightful American Journal of Public Health paper in a previous post. In this second of three posts, I will continue to unpack some of the content of her article, focusing on the distinction between correlation and causation.

Allocating health outcomes to risk factors, part 1

In 2017, Nancy Krieger, Professor of Social Epidemiology at the Harvard T.H. Chan School of Public Health, published a truly insightful paper in the American Journal of Public Health in which she raised several conceptual problems with allocating health outcomes to contributions from risk factors.

Pediatric social determinants screening

In late June, Public Agenda published a report on perspectives of low-income parents on pediatric screening for social determinants of health. A key conclusion suggests a substantial challenge.

Do Early Childhood Programs Work?

There’s a lot of evidence that social determinants of health are especially important in the early years of life. Experiences, resources, and opportunities available during childhood can influence health in ways that persist through adulthood. For these reasons, it’s especially important to evaluate the effectiveness of Early Childhood Programs, those interventions targeted at children, usually

Doorway to Health: Investigating the Housing Effect

Housing significantly affects health. In our homes, we experience the intersection of many health-related factors, and when we spend so much time in this environment, the cumulative effects of where we live can have long-term health consequences.

Does high rent affect health care spending and outcomes?

For low-income renters and residents in the U.S., access to affordable housing has strong ties to health care spending. People faced with high rent and housing costs often forego preventive care in an effort to lessen their already significant financial burdens.

Big Data Has Potential to Drive Big Decisions

This is a guest post by Lynn Todman, PhD, the executive director for population health at Spectrum Health Lakeland in St. Joseph, Michigan, where she also serves on the City Commission. She is a Robert Wood Johnson Foundation Culture of Health Leadership Fellow. 

Why Social Isolation, Poverty & Low Health Literacy Matter

The following is a brief interview with David R. Nerenz, Ph.D., Director Emeritus, Center for Health Policy and Health Services Research, Vice-Chair for Research, Department of Neurosurgery, Henry Ford Health System. Dr. Nerenz serves on the Drivers of Health advisory committee.

What Causes AIDS Deaths? (Part 2)

In the 1980s through the mid-1990s there was little the health system could do to address AIDS. Today there is a lot. Would we therefore attribute no deaths to AIDS in the 1980s and early 1990s to access to health care and some of them to that factor today?

Social determinants and/or health care?

An interesting tension was raised several times at the first Drivers of Health meeting in Princeton. (You can watch the webcast of the meeting here.) On the one hand, there’s a temptation — even a policy need — to separate social determinants and health care.

Education and Health: The work of Paula Braveman

Education is related to health. Better educated people tend to be healthier. Why? The pathways from education to health are varied and complex, as explained by Paula Braveman, one of the speakers at our Princeton meeting.

What Causes AIDS Deaths?

Here’s a puzzle: To what would you attribute deaths from AIDS today? Genetics? Behavior? Social or environmental factors? The health system (or its failure)? Something else? Once you have your answer, how would you know it was right? How would you test it? What evidence would you need? What studies would you do?

Racial identity and the health system

For centuries privileged classes have placed people into racial categories and acted upon them in ways that reflect and cement power. Racial discrimination has been woven into the fabric of many, if not all, U.S. institutions. The health system is not immune.

Health system cost-effectiveness

How much value do we obtain per dollar spent on the health system? How has that changed over time? How does it compare across countries? These are tough but important questions.

Social determinants over time

The risks to health faced by Americans long ago are different from those we face today. Some of the things that once killed many people (like poor sanitation) now kill many fewer. On the other hand, we now face new risks (like death from auto accidents) that didn’t exist a century ago.

Social determinant pathways are complex

The causal pathways from social determinants of health to health outcomes can be numerous and complex. Though some factors (like smoking) are directly related to health, others (like education or income) relate to health in a variety of indirect ways.

The value of health spending

The U.S. is the biggest spender on health care in the world, yet national health outcomes do not reflect this massive investment. This fact forces us to question the value of health care spending: are our health care dollars worth it?

What drives health?

What drives health? This is the big and challenging question my team and I are facing on a new, one – year project funded by the Robert Wood Johnson Foundation. This website is devoted to this question, and we invite you to engage with us as we explore it.