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 > > > > > > Met vriendelijke groet, > > > > Jaap Toet > > Adviseur Gezonde Leefomgeving > > > > > > T 030 - 28 63235 > M 06-48040726 > > [log in to unmask] > > www.utrecht.nl > > Gemeente Utrecht > > Volksgezondheid > > > > > > <https://www.facebook.com/GemeenteUtrecht> > <https://twitter.com/gemeenteutrecht> > <https://www.linkedin.com/company/gemeente-utrecht> > <https://www.utrecht.nl/nieuwsbrieven> > > > > > > [image: Standaard] <https://www.utrecht.nl/> > > > > > > > To leave, manage or join list: > https://listserv.yorku.ca/cgi-bin/wa?SUBED1=sdoh&A=1 > > To leave, manage or join list: https://listserv.yorku.ca/cgi-bin/wa?SUBED1=sdoh&A=1