Curious to know what our members think about the message this study sends
to policymakers and how we read the efficacy and or validity of a study
like this versus policymakers and those in other academic sectors?

Lauri Andress, Ph.D
cell 713 553 8192 Please excuse mistakes; doing too many things at one
time;  typing on a tiny keyboard or using voice dictation software

On Wed, Mar 25, 2020, 9:35 AM Toet, Jaap <[log in to unmask]> wrote:

> What list-members already knew!
>
>
>
> Social policies might not only improve economic well-being, but also health
>
> Over half of early life and education interventions studied had a positive
> effect on health
>
> *Date:*
>
> March 19, 2020
>
> *Source:*
>
> Columbia University's Mailman School of Public Health
>
> *Summary:*
>
> A comprehensive review of US social policies evaluated for their health
> outcomes found suggestive evidence that early life, income, and health
> insurance interventions have the potential to improve health. Scientists
> have long known that 'social' risk factors, like poverty, are correlated
> with health. However, until this study, there was little research carried
> out to understand whether it was actually possible to improve population
> health by addressing these risk factors with social policies.
>
> A comprehensive review of U.S. social policies evaluated for their health
> outcomes found suggestive evidence that early life, income, and health
> insurance interventions have the potential to improve health. Scientists
> have long known that "social" risk factors, like poverty, are correlated
> with health. However, until this study, there was little research carried
> out to understand whether it was actually possible to improve population
> health by addressing these risk factors with social policies. The findings
> are published in *The Milbank Quarterly*, a multidisciplinary journal of
> population health and health policy published by the Milbank Memorial Fund.
>
> advertisement
> ------------------------------
>
> "Since the 1960s, a large number of social policies that have been
> experimentally evaluated include health outcomes, but these were mostly
> overlooked. By tracking down these studies, we found a unique opportunity
> to inform evidence-based policymaking. It was sitting right there in front
> of us this whole time," said Peter Muennig, MD, a professor of Health
> Policy and Management at the Mailman School of Public Health at Columbia
> University. "Our goal was to conduct a comprehensive review of experimental
> studies of social and economic interventions that were not explicitly
> designed for the purpose of improving the health of participants. Health
> outcomes were often added as an afterthought and were overlooked." He
> added, "This is remarkable given the magnitude of expenditures in the
> nonmedical determinants of health in the United States and the weak
> evidence base supporting these investments."
>
> The systematic review of all known randomized social experiments in the
> United States that involved health outcomes included 5,876 papers, reports,
> and data sources, ultimately encompassing 60 papers, reports, or datasets
> from 38 randomized social experiments. These experiments spanned the period
> 1962-2018 and featured a range of policies, analytic approaches, and target
> groups and measured a wide variety of health outcomes.
>
> The final analysis was based on a sample of 450 unique health estimates
> across the 38 interventions. Of these, 77% were not able to reliably detect
> health outcomes because the sample was too small. Among those from which
> reliable estimates could be obtained, 49% demonstrated a significant health
> improvement, 44% had no effect on health, and 7% were associated with
> significant worsening of health. The most commonly reported outcome was
> mental health.
>
> Eleven of the studies included tested interventions in the domain of early
> life and education. Nine of the included studies examined the social and
> health impacts of income maintenance and supplementation programs. Twelve
> of the included studies focused on employment and welfare-to-work:
> team-based supported employment, job training programs, employment support
> services.
>
> The researchers found that early life and education interventions were
> associated with an 8% reduction in smoking. "Although this is a fairly
> small percentage, it could have wide implications and may be a proxy for
> other forms of risk-taking behaviors, such as condom or seatbelt use" noted
> Emilie Courtin, PhD, a fellow at Harvard University.
>
> Income support and health insurance programs showed the most promise in
> improving population health. For a very small number of studies, harmful
> effects of social policies on health were indicated. These were mainly
> concentrated among time-limited welfare-to-work interventions.
>
> The researchers point out that interventions in the domains of early life
> and education, income, and health insurance are particularly promising as
> population health policies. While many experiments were at high risk of
> bias, the research -- all based on the "gold standard" randomized,
> controlled trial, gives us confidence that income support programs save
> lives.
>
> Still, some studies that should have been able to measure health outcomes
> showed no health impact. This may indicate that they were true negative
> findings -- and that health care providers and insurers should not randomly
> invest in social policies and expect health benefits, noted Muennig.
>
> "Our study is exciting because it shows for the first time that it is
> possible for the government to improve health by making investments outside
> of the health system. The strong investments made by peer nations in
> welfare may explain why they have left the United States in the dust with
> respect to health and longevity. Still, policymakers need to be careful
> about how they make these investments, because they also have the potential
> to do harm."
> ------------------------------
>
> *Story Source:*
>
> Materials
> <https://www.mailman.columbia.edu/public-health-now/news/social-policies-might-improve-health-and-economic-well-being>
> provided by *Columbia University's Mailman School of Public Health*
> <https://www.mailman.columbia.edu/>. *Note: Content may be edited for
> style and length.*
> ------------------------------
>
> *Journal Reference*:
>
> 1.    Emilie Courtin, Sooyoung Kim, Shanshan Song, Wenya Yu, Peter
> Muennig. *Can Social Policies Improve Health? A Systematic Review and
> Meta-Analysis of 38 Randomized Trials*. *The Milbank Quarterly*, 2020;
> DOI: 10.1111/1468-0009.12451 <http://dx.doi.org/10.1111/1468-0009.12451>
>
>
>
> https://www.sciencedaily.com/releases/2020/03/200319125148.htm
>
>
>
>
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