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Brian Rahmer Profile picture
@brianrahmer
Dec 28, 2017 • 154 tweets • 151 min read Twitter logo Read on Twitter
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We are dying younger, in part, because of deliberate policy choices made over decades:
• Rejecting universal health care.
• Cutting taxes for the rich.
• Shunning income support.
• Abandoning universal child care.

Those choices increasingly set us apart in the world. #SDoH
“...any man’s death diminishes me,
because I am involved in mankind.
And therefore never send to know for whom the bell tolls; it tolls for thee.”
#SDoH #Interdependence #PEoH theincidentaleconomist.com/wordpress/us-l…
“We are the wealthiest nation on earth, but far from the healthiest, and things are getting worse, not better.” #SDoH #PEoH #HiAP #IRoS statnews.com/2018/01/04/lif…
“...it seems more sensible to pursue a fairer economy overall... one that recognizes in its distributive structure that every person is immeasurably valuable, deserving of life and dignity.” #SDoH #PEoH #HiAP #IRoS
Since the 1970s, the safety net has been diminished considerably. Labor regulations protecting workers have been rolled back, and funding for education and public programs has declined. The poor have been the hardest hit. #SDoH #PEoH #HiAP
Instead of just focusing on the overall decline in life expectancy, we need to start talking about these links between policy, and worsening income inequality and its relationship to the growing mortality gap. #SDoH vox.com/science-and-he…
When asked what specific issues cause them the most stress, Americans’ responses are:

•Health care (43%)
•Economy (35%)
•Trust in government (32%)
•Crime & hate crimes (31%)
•Unemployment & low wages (22%) •Climate & environment (21%)

#SDoH #PEoH apa.org/news/press/rel…
Recent comparisons of policies across two dozen countries show access to affordable, reliable childcare, played the biggest role in closing the gender wage gap & ensuring that new mothers could remain in the workforce. #SDoH #PEoH #HiAP #IRoS
The United States is facing the worst collapse in the trust of institutions — businesses, media, NGOs, government — ever recorded in the 17 year history of the Edelman #TrustBarometer. #PEoH #HiAP #SDoH cms.edelman.com/sites/default/…
Community vulnerability to diseases of despair like suicide and addiction comes from a failure of social solidarity and inclusion. #SDoH #HiAP #PEoH #IRoS theconversation.com/us-life-expect…
The right to a home is not just a matter of social cohesion and justice. Providing stable housing is an important upstream intervention to reduce avoidable deaths and improve health and wellbeing... #SDoH #PEoH #HiAP #IRoS
“...because we’re at the bottom of the totem pole, there’s no effective response from public officials.”

“I try to make it a point not to live every day on edge. Because my son is — he’s really good at picking up on something that isn’t right.” #SDoH commonwealthfund.org/publications/f…
The U.S. Can No Longer Hide From Its Deep Poverty Problem.

#SDoH #PEoH #HiAP #IRoS nytimes.com/2018/01/24/opi…
“...fueled by the world's perceptions of the country becoming less progressive and trustworthy & more politically unstable.” #SDoH #HiAP usnews.com/news/best-coun…
Cities and States Can Address the Affordable Housing Crisis: “...it is important for localities to ensure that they are not serving as purveyors of the nation’s deepening inequity.” #SDoH #HiAP #IRoS
“We need a whole new language — and a new way of seeing — to even begin to make sense of it.” #SDoH
“But too many Americans today are sacrificing into an empty void, with no returns for generations. At a certain point, it’s not sacrifice anymore—it’s just suffering.”
#SDoH #PEoH #HiAP #IRoS
In general, inequalities tend to be bad for health, and the U.S. is obviously the extreme. When you have high levels of inequality, it shapes health through the whole life course, from child mortality to conditions in old age... #SDoH #HiAP hsph.harvard.edu/magazine/magaz…
Neither wages nor health benefits have kept pace with corporate profits over the past 17 years, and that means health care is eating up a bigger share of paychecks that already aren’t going as far as they used to. #SDoH #PEoH #HiAP axios.com/the-erosion-of…
“Housing instability absolutely is a public health issue.”

“Many times we focus on things like health care & education as the roots to helping a community thrive. We need to be talking about housing too." #SDoH #PEoH #HiAP @megansandel @NCHH @maya_brennan
We have to say, “If you are part of the American community, you will have a place to live, you will have food to eat, you will have health care when you are sick, and you will be able to retire when you are old.” #SDoH #HiAP #IRoS #PEoH
Minimum wage improvements had a greater impact in the countries with economies performing below the OECD median. #SDoH #PEoH
Over three decades in which survival advances slowed in the US, educational performance weakened, social divides (including income inequality) widened, middle class incomes stagnated & poverty rates exceeded those of most rich countries. #SDoH #HiAP #PEoH bmj.com/content/360/bm…
“We can change this, but only if we change our priorities as a society.”

#SDoH #HiAP #PEoH #IRoS @amandaemac time.com/5138349/drugs-…
A lack of social services including universal healthcare, public health crises, and declining social mobility have all contributed to growing despair and failing health in the United States. #SDoH #PEoH #HiAP commondreams.org/news/2018/02/0…
“The reality is we have unusually high poverty because we have unusually high penalties for all four of these risk factors for poverty.” #SDoH #PEoH #HiAP #IRoS @ryanmfinnigan
“If you don’t have your other needs met, it’s a lot harder to keep up with your health.” #SDoH #PEoH #HiAP
“These policies—not a lack of work ethic, not immigrants & not people of color—are the real source of pain for so many Americans. To make America great for average Americans, we need to rewrite the rules of our economy so that it works for all of us” #SDoH
The Health Threats of Welfare Stigma: “...people with high levels of need were scared away from applying for welfare benefits by stigma.” #SDoH #PEoH #HiAP daily.jstor.org/the-health-thr…
Over the last few decades, economic inequality has increased, with strong growth at the top of the income distribution but no growth in the middle & bottom. In recent years mortality rates among Americans also have grown more unequal by income level. #SDoH
These conditions exist because of the policies and spending priorities. These decisions shape socioeconomic conditions, design of our communities, our health behaviors, access to health care & how all of these are distributed across people & places. #SDoH
“For each of these deaths, many more Americans are affected, either directly or through family and friends...” #SDoH #HiAP #PEoH
“As your society becomes more unequal, you are more likely to become depressed. If you have job insecurity, you are more likely to become depressed.” #SDoH #HiAP
“These dots all directly connect to health and healthcare spending.” #SDoH #PEoH #HiAP #IRoS
Updating the safety net in the U.S. for the 21st century is a project that is long overdue, and these ideas that put the comfort and dignity of workers at the core, not the bottom line of companies, are a step in the right direction. #SDoH #HiAP #PEoH fastcompany.com/40532249/what-…
Does a decades-long rise in ‘Deaths of Despair' among Americans signal an emerging crisis for U.S. capitalism and democracy? #SDoH #HiAP @jasonbellini @WSJ wsj.com/video/series/m…
“The bottom seven deciles of workers have seen annual growth of hourly wages of 0.5 percent or less since 2000.” #SDoH #PEoH #HiAP epi.org/publication/th…
“Our culture is getting less good at meeting those underlying needs for a large number of people — and this is one of the key drivers of the current epidemic of despair.” #SDoH #HiAP #PEoH #IRoS
“Policies based on ideology instead of evidence. Privatization and funding cuts instead of expanding effective programs.”

We’re living with the human costs of these failed approaches. #SDoH nytimes.com/interactive/20…
“Maintaining the highly unequal and unjust status quo is neither sufficient nor sustainable. We need to take aggressive measures to achieve economic justice.” #SDoH #HiAP prospect.org/article/econom…
“Generations of inequitable decision-making, in which our neighbors’ needs and voices were not present in the halls of power, have generated literally unlivable conditions in our historic African-American community.” #SDoH #PEoH
“Name the policies and practices that create and perpetuate the financial challenges facing millions of households in the US.” #SDoH
State by state, there are meaningful differences in social and economic factors by place and race, such as community connections and supports, schools, jobs, and safe neighborhoods that are foundational to achieving longer and healthier lives. #SDoH #HiAP countyhealthrankings.org/explore-health…
No child should have to grow up in poverty. All children & youth should have the chance for a healthy start to life. Communities can take action to help children gain a foothold and prepare them to become our future leaders. #SDoH #HiAP #PEoH #IRoS countyhealthrankings.org/explore-health…
The worst places for poor white children are almost all better than the best places for poor black children. #SDoH #IRoS #PEoH
“Over a broader time frame, our subjective well-being has declined across the board in each and every state... Whatever the reasons, our collective psyche is clearly suffering today.” #SDoH #HiAP #PEoH citylab.com/life/2018/03/t…
“Any notion of work-life balance gets thrown to the wind when precarious, volatile, and stagnant income becomes the new norm.” #SDoH slate.com/human-interest…
The U.S. Spends Far Too Little on Social Welfare. #PEoH #HiAP #SDoH
Three-fourths of the public favor a national Medicare-for-all plan open to anyone who wants it. #SDoH
“...communities are interconnected, so services that help one household or neighborhood succeed ultimately benefits everyone.” #SDoH #HiAP #Interdependence
“The absence of legal protections for minorities allowed for the construction of a complex system of segregation, including restrictive covenants, local policies, and informal practices among lenders, the real estate profession, & developers.” #SDoH #HiAP
“Health inequalities, and their social inequality antecedents, are therefore not unfortunate or inevitable outcomes, but amenable to public policy.” #SDoH #PEoH #HiAP #IRoS @TobaBryant & @DennisRaphael01 2018. oxfordbibliographies.com/view/document/…
“Using life expectancy and indicators of unemployment insurance, pensions and sickness insurance, we found a substantively and statistically significant association between welfare generosity and population health.” #HiAP #SDoH
“Any declines of the welfare state therefore should increase the social inequalities that create health inequalities and should be resisted.” #SDoH #HiAP #PEoH #IRoS @TobaBryant oxfordbibliographies.com/view/document/…
“We have never had a credible political movement of Americans focused on the overall improvement of American health. Instead, advocacy has been narrow, temporary, and/or outsourced to entities that have a variety of other priorities.” #SDoH #PEoH #HiAP healthaffairs.org/do/10.1377/hbl…
Majority of Homes Not Affordable for Average Workers.

“The median home price in the first quarter to date is not viable in 68 percent of the 466 U.S. counties analyzed.” #SDoH #HiAP #PEoH multihousingnews.com/post/report-re…
“This is an effort that requires concerted action on a vast scale: a welfare state to alleviate poverty; environmental clean-up, access to care including mental health services; occupational health reform to reduce disabilities inflicted by work.” #SDoH
The US health investment portfolio is out of balance, with too much spent on certain aspects of health care & not enough spent to ensure social, economic & environmental conditions that are vital to maintaining health & well-being. #SDoH #HiAP #PEoH #IRoS healthaffairs.org/doi/full/10.13…
“...a shortsighted political focus on reducing spending in such areas as education, housing, and economic revitalization exacerbates these root causes and magnifies disease burden and health spending.” #SDoH healthaffairs.org/doi/full/10.13…
“It will necessitate bold cross-sectoral policy action including changes to wider social and economic policies such as social protection, taxation, employment and housing policy, as well as health policy.” #SDoH #PEoH #HiAP #IRoS nature.com/articles/s4159…
The findings come at a time when U.S. life expectancy has dropped for two straight years.

"We should be doing everything we can to prevent people from experiencing wealth shocks.” -@shwoolf #SDoH #HiAP #IRoS
“This confluence of troubles may seem overwhelming. It suggests, however, that the only way out is for people directly harmed by the economic and political system to fight as one against the few who benefit from it.” #SDoH #MLK50 theatlantic.com/magazine/archi…
Large Number of People Skipping Necessary Medical Care Because of Cost.

“More Americans fear medical bills than they do serious illness.” #SDoH westhealth.org/press-release/…
“...we are in a period when declines in key public health indicators may be wrought by policies that ostensibly have little to do with health—such as tax policy.” #SDoH #HiAP #PEoH @davechokshi jamanetwork.com/journals/jama/…
“If we don’t take steps to rewrite the rules of how our economies work, then we condemn ourselves to a future that remains unequal for good. That’s morally bad & economically disastrous, risking a new explosion in instability, corruption & poverty.” #SDoH theguardian.com/business/2018/…
“...imposing strict requirements on already vulnerable populations, particularly when coupled with an aggressive effort to slash funding and shrink public assistance programs, could be disastrous for those in need.” #SDoH #HiAP #PEoH time.com/5235889/trump-…
“It is of critical importance to determine which policies across all health determinants are most effective in moving each component, and in moving both together most efficiently.” #SDoH #HiAP #PEoH
“...we hope that this will bring attention to the importance of equity weighting since such value judgments may vary across different population groups.” #SDoH #HiAP
“The sociopolitical power that economic rents afford is essential to understanding the persistence of inequality across generations & the political forces that must be overcome to break down barriers to mobility for marginalized groups.” #SDoH #HiAP #PEoH thenation.com/article/what-t…
“Workplace environments in the United States may be responsible for 120,000-excess deaths per year.” #SDoH #CDoH #PEoH #HiAP
“The United States has the weakest safety net among the Western industrialized nations, devoting far fewer resources as a percentage of gross domestic product to welfare programs than do other wealthy countries.” #SDoH #PEoH #HiAP nytimes.com/2018/04/15/opi…
The implications are that the country's poorest neighborhoods require substantially more supports for young children but currently have many fewer publicly available services, supports, and investments. #SDoH #PEoH #HiAP #IRoS
Eliminating substandard housing — the misery it causes and the human potential it robs — has straightforward solutions...

“It’s not that we don’t know what needs to happen, we are just deeply and chronically underfunding those solutions.”

#SDoH #HiAP
“Rising inequality is about more than just a widening gap in wealth and income. The richest Americans are also living much longer, healthier lives than everyone else.” #SDoH #HiAP #PEoH #IRoS
“The result is that the foundation of the middle class continues to be gnawed away even as help-wanted ads multiply.” #SDoH #PEoH #HiAP @RobertGebelhoff
“These differences in opportunities are the result of more than 100 years of the ways we have chosen to shape and govern our communities. Redlining, unfair bank lending, all of these things have significantly affected opportunity.” #SDoH #HiAP
“Something has gone wrong with homeownership in America. Once the ladder to wealth, economic divides in real estate have increasingly become a driver of inequality, further entrenching political and economic privilege.” #SDoH #PEoH #HiAP theamericanconservative.com/urbs/homeowner…
Swimming Upstream: Policies to Ensure Broadly Shared Prosperity by Restructuring the Market

#HiAP #PEoH #SDoH #IRoS cepr.net/publications/b…
Differences in sectoral power across and within forms of welfare states can shape the resources and supports available to those occupying various social locations during important periods of the life-course. #SDoH #HiAP
So what are we really talking about when we talk about the minimum wage?

#SDoH #HiAP #PEoH #IRoS @apcbapcb
“The most significant political legacy of the 2008 financial crisis and the Great Recession could turn out to be the ongoing shift in the way Americans understand their class position.”

#SDoH #HiAP #PEoH @sarahljaffe newrepublic.com/article/148130…
Structural disadvantages & adverse socioeconomic circumstances produce severe adverse health effects. This amplifies a much older narrative not capturing headlines: Poor health & lives of despair are a long-known story of race & socioeconomic status. #SDoH healthaffairs.org/do/10.1377/hbl…
These are questions of policy priorities and values.

“...perhaps we need to advocate for more guardians against ourselves and our dangerous impulse to fix the problem we helped create and to grow our industry in general.”
If every state achieved the performance of the top-ranked state on each Scorecard indicator, the gains in health outcomes would be dramatic. At current improvement rates it may take many years or decades for states & the nation to see such progress. #SDoH
“Power matters in all sectors. Its strongest effects act against employment and real wages in labor markets.” ineteconomics.org/perspectives/b…
“A society’s health—and healthcare system—serves as a window into its soul: it sheds light on the balance of class power, on political struggles long settled and still underway, and on who the society privileges and who it lets die.” #SDoH #HiAP @awgaffney dissentmagazine.org/article/crisis…
“A wide net should be cast in terms of conceptualizing poverty reduction as being in our self-interest. This sense of a broad awareness surrounding the costs of poverty can be referred to as enlightened self-interest.” #SDoH #HiAP #PEoH
“In communities on the financial brink, desperation and stress take a toll that lingers throughout life. Children grow up without access to basic requirements for human development.” #SDoH #HiAP usnews.com/news/healthies…
Many people do not realize that only 1.4 million families with children receive income support from TANF, even though 8 million families with children live in poverty. #SDoH #HiAP #PEoH @heynisha urban.org/urban-wire/f-t…
“For individuals who earn persistently low wages, putting up additional barriers to receiving SNAP will not improve their labor market prospects or increase mobility.” #SDoH
“The findings give a hint of what's at stake in the debate over the federal safety net." #HiAP #SDoH #PEoH latimes.com/business/hiltz…
“Social underfunding probably has more long-term implications than underinvestment in medical care. If the underspending is on early childhood education — one of the key socioeconomic determinants of health — then there are long-term implications.” #SDoH
“For officials who feel it’s only fair to make people work for government aid, the question of whom it’s fair to exempt gets much murkier.” #SDoH nytimes.com/2018/05/15/ups…
The figure includes the 16.1 million households living in poverty, as well as the 34.7 million families that are Asset Limited, Income Constrained, Employed. This group makes less than what's needed "to survive in the modern economy." #SDoH #HiAP
“...your child care worker, your parent on Social Security, the cashier at your supermarket, the gas attendant, the salesperson at your big box store, your waitress, a home health aide, an office clerk.” #SDoH #HiAP unitedwayalice.org/home
“We are seeing the consequences of these policies now, and they will follow today’s children throughout their lives.”

#SDoH #HiAP #PEoH
The data on low-income workers and corporations shows us the real problem in a world of increasing income inequality, where the rich are accumulating more & more wealth while incomes of middle & lower-income Americans fall behind. #SDoH vox.com/policy-and-pol…
“...a stable political community required a strong middle class. Without it, the polity will be a city, not of freemen, but of masters and slaves...” #SDoH #HiAP #PEoH nybooks.com/articles/2018/…
“That is the real polarization that has broken America since the 1960s. It’s the protected vs. the unprotected, the common good vs. maximizing and protecting the elite winners’ winnings.” #PEoH #HiAP #SDoH time.com/5280446/baby-b…
Report on the Economic Well-Being of U.S. Households in 2017

“Four in 10 adults, if faced with an unexpected expense of $400, would either not be able to cover it or would cover it by selling something or borrowing money.” #SDoH #HiAP federalreserve.gov/publications/f…
“Middle-income households have shrunk as a proportion of the population since the 1960s. Those earning between 50 percent & 150 percent of the median income represented just 48 percent of total households in 2016, compared with 58 percent in 1968.” #SDoH blogs.imf.org/2018/05/15/map…
“The US fell behind the OECD in reducing pediatric mortality rates in the 80s & has stayed there since, across administrations, there is no reason to make this a partisan issue. We should study the causes of infant & child mortality & address them.” #SDoH
Having so many underperforming communities makes the country less productive and resilient. The U.S. increasingly depends on a relatively small number of economic engines.
And this divergence is accelerating.

#SDoH #HiAP #Interdependence
The U.S. death rate rose last year, and 2017 will likely be the third straight year of decline in American life expectancy.

#SDoH #HiAP #Interdependence nbcnews.com/health/health-…
A serious fight against poverty requires both a more generous safety net and a better-functioning labor market.

#SDoH #HiAP #PEoH #IRoS @eliselgould @Schieder_ epi.org/publication/50…
The Demographics of Wealth
2018 Series

#SDoH #HiAP #PEoH stlouisfed.org/~/media/Files/…
“The nature of the meritocracy may differ more or less in each instance, but the underlying story has been strikingly similar across the ages, and across continents.” #SDoH
Executives of big U.S. companies suggest that the days of most people getting a pay raise are over, and that they also plan to reduce their work forces further. #PEoH #HiAP #SDoH axios.com/broad-based-pa…
Not only have many public health interventions in the US been hugely successful, but they’ve also saved more money than they’ve cost.

Yet we spend relatively little money in that domain and far more on medical care that returns less value for its costs.

“This set of facts seems to me problematic. Your heart doesn’t even have to bleed to care. The United States risks its prosperity by leaving so many Americans behind.” #SDoH @portereduardo

nytimes.com/2018/05/29/bus…
“Families absorb the long-term emotional and social strain of instability that surrounds lives of constant precarity.” #SDoH #HiAP @meeshellchen @thenation thenation.com/article/how-ki…
“40 million Americans live in poverty. More than five million eke out an existence amid the kind of absolute deprivation normally associated with the developing world.” #SDoH #HiAP theguardian.com/us-news/2018/j…
Segregated, really segregated, or ultra-segregated?

Poor people die younger in the U.S. That skews American politics.

#SDoH #HiAP #PEoH
“The US is storing up immense problems for itself. It’s extremely shortsighted.”

“We are building a society where wealth & privilege will dominate everything, where you will move toward the privatization of ever more government services.”

latimes.com/nation/la-na-u… @JennyJarvie
“underfunding of social services relative to medical care probably played a significant role in both spending & outcomes. I’d like to see more experimentation with investments in nonmedical sectors we know also affect health including housing & education.”
A timely, multidimensional view of poverty-related need...

“The opportunity gap is shortening all of our lives. Since 1998, US life expectancy has been lower than in other industrialized countries. It stopped increasing in 2012 and is now decreasing.” #HiAP #SDoH spotlightonpoverty.org/spotlight-excl…
Housing is creating the most pressure on family budgets. Media attention focuses on surging prices in education & medical care but the increasing cost of shelter has been the single largest increase in US family budgets over the last 15 years. #SDoH #HiAP ncsha.org/wp-content/upl…
Suicide rates have increased in nearly every state over the past two decades, and half of the states have seen suicide rates go up more than 30 percent. #SDoH #PEoH #HiAP
Federal, state, and local housing policies must be used to combat the persistence of income inequality and racial segregation as urban populations grow and neighborhoods are revitalized.

#SDoH #HiAP #PEoH #IRoS
“This is an opportunity to show there are so many things we can do besides healthcare. Many of our diseases have origins in the community; we need to go where the problems are. Our health leaders of the future are going to be city councils & mayors." #SDoH governing.com/topics/health-…
“If we are serious about moving toward a future with less poverty, we must strengthen the social safety net and constructively remedy racial inequality.” #HiAP #SDoH #PEoH epi.org/publication/th…
“Precarity isn’t the major problem in the American labor market. It’s that wages are stagnant or worse, benefits are eroding, and much labor is dull, alienating, pointless & sometimes dangerous.” #SDoH #HiAP #PEoH @DougHenwood jacobinmag.com/2018/06/gig-ec…
“If the federal government wants to promote employment, education and healthcare, it needs to invest more, not less, in housing.” #SDoH #HiAP
“We are experiencing an affordable housing crisis, especially for very low-income families.”

The low-wage workforce is projected to grow over the next decade, particularly in service-sector jobs such as personal-care aides and food-preparation workers.
The success of permanent supportive housing has been overshadowed by increases in people becoming newly homeless due to the lack of affordable housing. Preventing & ending homelessness will require creating housing that is affordable to all.
Decades of the government helping the rich are coming home to roost.

“More broadly, the divergence between the performance of the overall economy and the lot of the average American worker has exploded over the past few decades.”

#SDoH #HiAP #PEoH vice.com/en_us/article/…
For the biggest group of American workers, wages aren’t just flat. They’re falling.

The falling wages promise to exacerbate historic levels inequality. Within the labor force, it means workers who were already making less are falling further behind. #SDoH washingtonpost.com/news/wonk/wp/2…
Low Income Workers Really Do Struggle to Cover Rent.

#SDoH #HiAP #PEoH @MattBruenig peoplespolicyproject.org/2018/06/18/low…
More than 38 million US households have housing cost burdens, leaving little income left to pay for food, healthcare, and other basic necessities. Federal housing assistance reaches only a fraction of the large & growing number of households in need. #SDoH jchs.harvard.edu/state-nations-…
“Many, many studies conclude that investing in public health is more effective than continually increasing spending on expensive treatments. So why doesn’t the US spend more on public health?”

#SDoH #HiAP #PEoH @aaronecarroll @HCTriage @IncidentalEcon theincidentaleconomist.com/wordpress/heal…
Every childhood is critical to health equity.

#SDoH #Interdependence #HiAP
And here’s a question that’s never asked: What does poverty actually feel like, especially to a child?

“It sinks deep into your bones, into the very sinews of your life and never leaves you. Poverty is more than the numbers that prove it...” #SDoH tomdispatch.com/blog/176437/
“We all need a roof over our heads, we all need to survive. Nor does the Earth belong solely to humans.”

“Everything you see around you comes from nature. That’s the basis of everything. Economics is the wrong word. It should be … ecolo-mics.” #SDoH
“...the stress of providing for their household amidst crushing student debt, housing prices, and healthcare costs eventually became too much to bear.

America is rapidly becoming a place where only the rich can survive.” #SDoH #PEoH #IRoS gritpost.com/suicide-capita…
“We actually know what to do. We just lack the will.”

Thanks to a lack of adequate social safety-nets, industrial policy, and convergence of the public and private sector, more & more responsibility for coping with a fast-changing labor market & bifurcated economy has been left to the individual. #SDoH #HiAP ft.com/content/a11fb8…
“The second thing to know is that we are next in line for the chopping block. As the population of the resentful expands, the circle of joy near the top gets smaller.” #SDoH
“...it’s a really broad umbrella that often just looks like poverty... There’s no consistent evidence that removing kids is, on average, beneficial, and there’s substantial evidence that it does harm.” #SDoH
America Has A Health Care Gap, And Insurance Alone Won't Fix It...

“Relative health tracks relative wealth.”

“This pattern — one of health divides mirroring social divides — flourishes on an even more local level.” #SDoH #HiAP #PEoH #IRoS huffingtonpost.com/entry/opinion-…
“Reports from a Sinking Society”

#SDoH #HiAP #PEoH #IRoS @thomasfrank_
“To challenge inequality requires a recognition of the structures of power that produce it.” #SDoH
Increasing neighborhood income inequality is a driving force behind challenges facing low-income communities, including elevated rates of crime, failing schools, and poor health outcomes. #SDoH 21cc.jhu.edu/publications/p…
“The need for stable and affordable housing is felt urgently by communities, and this emergency is manmade... it remains to be seen whether there will be a shortage of political will to meaningfully address these issues.” #SDoH #HiAP #PEoH
“Our results show that over the last nine decades, when unions expand, whether at the national level or the state level, they tend to draw in unskilled workers and raise their relative wages, with significant impacts on inequality.” #SDoH #HiAP
“Our government does less for us when we’re out of work than just about anyone else’s.”

“Given all this, it seems safe to say that America’s aberrantly weak wage growth is the product of political decisions made at the national level.” #SDoH #HiAP #PEoH nymag.com/daily/intellig…
“Housing in America may be a microcosm of the nation itself: a bit less dynamic, far more costly and uncomfortably more unequal than we’d like.”

#SDoH #HiAP #Interdependence marketwatch.com/story/the-stat…
The US Health Care System Exacerbates Income Inequality

#SDoH #HiAP #PEoH #IRoS
“The current political salience of inequality and stagnation provides a window of opportunity for a fundamental reassessment of how growth and prosperity are being pursued...” #SDoH #HiAP #PEoH voxeu.org/article/inequa…
“Their feelings about government don’t appear connected to their own direct experience of it. But those feelings are shaped by opinions about other people’s reliance on government aid — specifically, on ‘welfare’.” #SDoH #PEoH #HiAP nytimes.com/2018/08/06/ups…
“The average household in the top 10 percent of today’s wealth distribution is almost three times as rich as the average household in the top 10 percent of 1971’s distribution. Meanwhile, the average household in the bottom half is slightly poorer.”

#SDoH bloomberg.com/view/articles/…
Growth is only worth something if it improves people’s lives.

“If the U.S. wanted to become serious about pursuing wellbeing as the ultimate goal of economic advancement, there are blueprints.” #SDoH #HiAP #PEoH #IRoS longreads.com/2018/08/06/hap…
8 Policies that Have Contributed to Place-Based Health Disparities across Generations

#HiAP #SDoH #Interdependence @ChangeLabWorks medium.com/changelab-solu…

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More from @brianrahmer

Brian Rahmer Profile picture
Aug 7, 2018
A Balanced Investment Portfolio For Equitable Health And Well-Being Is An Imperative, And Within Reach

#SDoH #HiAP #Interdependence
Social Determinants As Public Goods.

@LenMNichols & @LaurenTaylorMPH demonstrate that the underprovision of interventions on #SDoH can be addressed through a novel but practical community financing mechanism.

#Commons #Interdependence healthaffairs.org/doi/10.1377/hl…
“While the degree to which human beings pursue that which they think is good for them has not and will probably never change, what they believe is good for them can change and from time to time has, radically.”

#SDoH #HiAP #PEoH #IRoS
Read 7 tweets
Brian Rahmer Profile picture
Jan 3, 2018
The effects of public health policies on health inequalities: a review of reviews. Thomson et al, 2017.

“...fiscal and regulation policies were more beneficial for reducing or preventing health inequalities than educational campaigns.”

#SDoH #PEoH #HiAP thelancet.com/pdfs/journals/…
“...how broad policy initiatives for tackling inequalities in health that start off with social determinants (upstream) approach drift downstream to largely individual lifestyle factors, as well as the general trend of investing a the individual level.”
“The consequence of this is a widespread public sector culture in which well-meaning policymakers, practitioners, researchers and members of the public collude in sustaining a ‘cargo cult’ of health behaviorism.” #SDoH #HiAP #PEoH
Read 28 tweets

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