social determinants of health

Umair Shah’s story isn’t an uncommon one in public health. Starting out in medicine, with a career as an emergency department doctor, he said it quickly became clear that most of what impacts our health happens outside the hospital and in the community. Today, that philosophy drives his work as executive director of Harris County Public Health (HCPH) in Houston, Texas — an agency that serves the third-largest county in the nation, home to about 4.5 million residents. In fact, Shah, who first joined the agency in 2004 and become director in 2013, said the agency’s mantra is this: “Health…
To get a clearer sense of just how bad our drug overdose problem has gotten, look no further than this year’s County Health Rankings. The annual report found that after years of declining premature deaths, that rate is on the rise and due primarily to overdose deaths. It means we could be seeing the first generation of American kids with shorter life expectancies than their parents. “We often think of the opioid crisis either as happening in very rural communities or as an urban issue,” Kate Konkle, Action Center Team director for County Health Rankings & Roadmaps, told me. “But this is…
A couple months ago, we reported on a study that found raising the minimum wage to $15 could have prevented thousands of premature deaths in New York City alone. Now comes more science on the life-saving benefits of higher wages — this one found that just a modest increase in the minimum wage could have saved the lives of hundreds of babies. It’s yet another reminder that the movement for a living wage is also a movement toward a healthier nation for all. Published last week in the American Journal of Public Health, the study examined the impact of state-based minimum wage laws on the rate of…
Poverty and poor health often go hand-in-hand. However, the effects of poverty may be especially profound for children, who are moving through critical developmental and educational phases in their young lives. Knowing that this social determinant of health can lead to a lifelong struggle with poor health and disease, the American Academy of Pediatrics is now calling on pediatricians to screen their young patients for poverty. Connecting low-income patients with social services and assistance is not necessarily new for many health care providers, but the fact that the nation’s leading…
In the U.S., the gap in life expectancy by income is getting wider. To be even clearer: Life expectancy for people with higher incomes has gone up over time, while life expectancy for people earning lower incomes has actually declined. In “The Growing Gap in Life Expectancy by Income: Implications for Federal Programs and Policy Responses,” which the National Academies of Sciences, Engineering and Medicine released last week, authors analyzed life expectancy patterns among Americans born in 1930 and compared them with projections among a group of Americans born in 1960. They found that top-…
As public health practitioners increasingly look upstream to identify the determinants that put people on a trajectory toward lifelong health and wellbeing, early childhood is often tapped as a pivotal intervention point. Now, a new tool is available that practitioners can use to measure neighborhood-level opportunity indicators that are fundamentally linked to children’s health. In the November issue of Health Affairs, researchers presented the newly developed Child Opportunity Index for the 100 largest U.S. metropolitan areas. The index covers three domains of opportunity: educational,…
Yesterday, the nation celebrated its workers. However, new research finds that most workers face fewer and fewer reasons to rejoice. Last week, the Economic Policy Institute (EPI) released a new report finding that hourly wages fell in the first half of 2014 when compared to the first half of 2013. And those wages fell for nearly all groups of workers, including those with bachelor’s degrees and higher. This isn’t a new trend, just one that’s quickly heading toward crisis proportions. The report, “Why America’s Workers Need Faster Wage Growth — And What We Can Do About It,” states that…
by Anthony Robbins, MD, MPA I first heard the name Thomas Piketty on a trip to France.  Now his immense book, Le capital au XXIe siècle (Capital in the Twenty-First Century) sits on my bedside table (in both the original French and the English translation).  It is a best seller in the US and in France. I have read reviews (here, here), attacks, defenses, and other essays that take off from Piketty’s work. I even had the opportunity to hear him live, addressing a class at MIT. Having learned Piketty’s major observations and arguments with the MIT students and followed the debate about his work…
This year’s County Health Rankings once again illustrate why geography and good health go hand-in-hand. They’re also a poignant reminder that there may be no better way to improve health for all than by focusing on the social determinants of health. Released earlier this week, the 2014 County Health Rankings compare each state’s counties on 29 factors that impact health, from tobacco use to high school graduation rates to access to healthy food choices. In examining the differences between counties, the report found that the least healthy counties were home to twice the premature death rate,…