Challenges to an integrated population health research agenda: Targets, scale, tradeoffs and timing

Gottlieb, Laura M.; Glymour, M. Maria; Kersten, Ellen; Taing, Elizabeth; Hagan, Erin; Vlahov, David; Adler, Nancy E.

doi:10.1016/j.socscimed.2015.11.004

Cited by 10 publications

(7 citation statements)

References 74 publications

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“…In the realm of smoking during pregnancy they have not been brought to scale and never will. Intervention success is contingent upon local factors such as public and political will, cultural differences and other social and environmental variables [17]. Farley challenges researchers to instead focus on minimalist interventions that can be scaled to reach large fractions of the population.…”

Section: Odds Ratio Estimates Pretermmentioning

confidence: 99%

The Use of Vital Statistics Data for Research of Consequence: Birth Outcomes and Population Health in a Rural Region

Kozinetz¹

2017

J Epid Prev Med

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Objective: The Affordable Care Act (ACA) has influenced increasing interests in population health and population health outcomes. The purpose of this study was to exemplify the importance of using existing vital statistics data for understanding and monitoring health outcomes and consequentially health disparities at the population level. Data from birth records for two geographic regions from 2009-2014 were compared; low birth weight (LBW) and preterm delivery (PD) were used as surrogates for population health outcomes.Methods: A population-based, multi-year, cross-sectional study design using a pooled dataset of birth records from Tennessee (TN) was the framework for the analyses. A sub-population from North East TN (NE TN) was compared to TN. Logistic regression was used to estimate odds ratios. Attributable risks were calculated to translate the findings from conditional associations to population-level associations to help inform public health policy decision-making. Multivariate analyses demonstrated that mothers who were at each end of the age spectrum, of very low household income level and reported cigarette smoking pre-pregnancy or during pregnancy had increased risk of a LBW or PD infant. During the years of observation, 39 to 50% of the total incidence of LBW in the group of women who smoked cigarettes prior to pregnancy was attributable to smoking cigarettes. Conclusions:Existing data, such as vital statistics data, should be used routinely to identify geographic areas for which programs or policies can be implemented to reach large portions of populations. Reducing prenatal smoking, for example, has the potential to reduce a large fraction of adverse birth outcomes such as LBW and PD. For the geographic area we evaluated, 39 to 50% of LBW could be prevented by devising population-based smoking cessation programs or policies for women of child-bearing age. With recent emphasis on prevention and well-baby care in the ACA, there is potential to increase attention to this problem, implement evidence-based prevention programs and monitor program effectiveness with existing birth record data. Following this model, we can attain population health goals and address health disparities.

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Section: Odds Ratio Estimates Pretermmentioning

confidence: 99%

The Use of Vital Statistics Data for Research of Consequence: Birth Outcomes and Population Health in a Rural Region

Kozinetz¹

2017

J Epid Prev Med

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“…In contrast to individually focused behavioral interventions such as counseling and education, efforts that focus on social and physical contexts are suggested to be more effective based on their wider reach and potential for sustainability. ( Adler et al, 2016 , Frieden, 2010 , Gottlieb et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Perceived neighborhood disorder, racial-ethnic discrimination and leading risk factors for chronic disease among women: California Behavioral Risk Factor Surveillance System, 2013

Plascak

Hohl

Barrington

et al. 2018

SSM - Population Health

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Social environmental factors are theoretically identified as influential drivers of health behaviors – tobacco smoking, alcohol consumption, and physical activity – related to chronic disease disparities. Empirical studies investigating relationships involving social environmental factors have found that either greater interpersonal racial-ethnic discrimination or perceived neighborhood disorder were associated with adverse health behaviors, with potentially larger effects among women. We simultaneously tested whether measures of perceived racial-ethnic discrimination and perceived neighborhood disorder were associated with physical activity, alcohol consumption and tobacco smoking; lifestyle risk factors of major chronic disease among women. Data were from the 2013 California Behavioral Risk Factor Surveillance System. In addition to demographic and socioeconomic factors, women self-reported experiences with racial-ethnic discrimination and perception of neighborhood disorder (i.e., crime safety, traffic safety, and aesthetics/physical disorder). Survey-, and inverse probability of censoring-weighted regression models of each chronic disease risk factor were used to investigate associations involving racial-ethnic discrimination and neighborhood disorder, controlling for potential confounders. Perceiving racial-ethnic discrimination and greater neighborhood disorder were associated with a greater tobacco smoking prevalence. Experiences of racial-ethnic discrimination were associated with greater alcohol consumption among African American and Latino women, but not White women. Similarly, African American women reporting experiences with racial-ethnic discrimination report engaging in physical activity about half as much time as women reporting no racial-ethnic discrimination. Increases in perceived neighborhood disorder were associated with increases in alcohol consumption. All associations with social environmental factors were adjusted for potential confounders and each other. Neighborhood disorder and racial-ethnic discrimination may be important, independent contributors to chronic disease risk through relationships with tobacco smoking, alcohol consumption, and physical activity.

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“…The SDoH approach calls for researchers to better understand how complex, multilevel factors produce (or fail to produce) health and well‐being (Bachrach & Daley, ; Gottlieb et al, ). While behavioral‐ or individual‐level actions contribute to health, there is growing acknowledgment that community context is critically important and should be more firmly integrated into health‐related research (Adler & Stead, ; Alley, Asomugha, Conway, & Sanghavi, ; Braveman et al, ; Robert, ; Syme & Ritterman, ).…”

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confidence: 99%

Foreclosure Risk and Community Health: Does Social Capital Have a Protective Effect?

Daley¹,

Goerdel²,

Pierce³

et al. 2018

Policy Studies Journal

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This study draws upon the social determinants of health framework to model and test the extent to which a community's social capital is health protective in the face of a substantial economic shock, namely the recent foreclosure crisis. U.S. county-level data are used to analyze potential moderating effects of social capital on health given a community's foreclosure risk. We rely upon established social capital measures for U.S counties and merge them with county level foreclosure risk scores constructed by the U.S. Department of Housing and Urban Development (HUD). While theorists suggest that social capital's effect on health and other outcomes may be durable over time there have been few empirical tests of this.We interact established social capital indicators measured at two points in time with foreclosure risk to predict overall self-reported health. Our results provide strong support suggesting that high levels of social capital are health protective. Communities with high levels of social capital that are facing high foreclosure risks report significantly better aggregate health outcomes than comparable communities facing the same level of foreclosure risk, but lower levels of social capital.

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Challenges to an integrated population health research agenda: Targets, scale, tradeoffs and timing

Cited by 10 publications

References 74 publications

The Use of Vital Statistics Data for Research of Consequence: Birth Outcomes and Population Health in a Rural Region

The Use of Vital Statistics Data for Research of Consequence: Birth Outcomes and Population Health in a Rural Region

Perceived neighborhood disorder, racial-ethnic discrimination and leading risk factors for chronic disease among women: California Behavioral Risk Factor Surveillance System, 2013

Foreclosure Risk and Community Health: Does Social Capital Have a Protective Effect?

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