Social determinants of health in the news
By Austin Frakt
Social determinants of health comes up from time to time in health policy news, reports, and scholarly articles. Here are quotes from five of these that caught my eye recently.
1. Confronting Structural Racism in Research and Policy Analysis, Urban Institute
In November 2018, the Urban Institute hosted a roundtable discussion with 23 organizations representing policy research, academia, and philanthropy to share approaches, insights, and lessons from our respective efforts to confront structural racism in our research and policy analysis. This brief discusses the rationale for these efforts at implementing institutional change; the range of challenges and constraints facing different types of research organizations; and our experience to date with specific tools and strategies. We aim to advance understanding of and attention to structural racism in the work of our own institution and in the larger field of policy research.
US air pollution rules could be hugely insufficient in preventing deaths, experts are concluding from a new study of the likely causes of death of 4.5 million veterans.
Published in the peer-reviewed journal Jama, the research finds that 99% of deaths from illnesses linked to a certain type of air pollution occur in people who are exposed to lower levels than the Environmental Protection Agency (EPA) currently deems acceptable.
3. Declines In Pediatric Mortality Fall Short For Rural US Children, Health Affairs
We used mortality data from the Centers for Disease Control and Prevention to ascertain whether children living in rural areas experienced declines in mortality over the period 1999–2017 that paralleled those for the nation as a whole. Throughout the study period and across all age groups, rural children experienced higher mortality rates than their urban peers. Among rural children, non-Hispanic black infants and American Indian/Alaska Native children were particularly at risk.
As a society, we’ve effectively decided that people shouldn’t die on the street, but it’s acceptable for them to live there. There are more than half a million homeless in the U.S., about a third of them unsheltered—that is, living on streets, under bridges, or in abandoned properties. When they need medical care or simply a bed and a meal, many go to the emergency room. That’s where America has drawn the line: We’ll pay for a hospital bed but not for a home, even when the home would be cheaper.
5. The Impacts of SNAP Participation on Mortality Rates, by Charles Courtemanche, Christian Gregory, Jordan Jones, and James Marton
We find evidence that higher SNAP participation reduces the overall mortality rate. Specifically, a one percentage point increase in the SNAP participation rate reduces the overall mortality rate by about 6.68 deaths per 100,000 population on average, or by about 0.81% of the mean overall mortality rate. These mortality reductions are concentrated most heavily among males, whites, and adults aged 20-64. We identify reductions in deaths from major cardiovascular disease and malignant neoplasms as major drivers of these estimated effects, and we also estimate a significant reduction in suicides in some areas.