Abstract
Americans have significantly poorer health outcomes and shorter longevity than citizens of other industrialized nations. Poverty is a major driver of these poor health outcomes in the United States. Innovative anti-poverty policies may help reduce economic malaise thereby increasing the health and longevity of the most vulnerable Americans. However, there is no consensus framework for studying the health impacts of anti-poverty social policies. In this paper, we describe a case study in which leading global experts systematically: (1) developed a conceptual model that outlines the potential pathways through which a social policy influences health, (2) fits outcome measures to this conceptual model, and (3) estimates an optimal time frame for collection of the selected outcome measures. This systematic process, called the Delphi method, has the potential to produce estimates more quickly and with less bias than might be achieved through expert panel discussions alone. Our case study is a multi-component randomized-controlled trial (RCT) of a workforce policy called MyGoals for Healthy Aging.
Highlights
Aristotle postulated that the social environment is an important determinant of human health [1].In the mid-nineteenth century, Rudolf Virchow conducted the first epidemiologic investigation showing the relationship between social conditions and health, documenting what would later come to be known as the “social determinants of health” [2,3]
The 20th century saw social policy and health policy begin to converge in Europe and Latin America [4,5], with the World Health Organization formally recognizing the social determinants of health as “the conditions in which people are born, grow, live, work and age” [3]
The Affordable Care Act in the United States led to billions of dollars spent on the social determinants of health in the hope of preventing disease before it occurs [6,7]
Summary
There are a large number of social policy experiments conducted each year in the US, but it is difficult to measure their impacts on health. Public Health 2020, 17, 3028; doi:10.3390/ijerph17093028 www.mdpi.com/journal/ijerph
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