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Brian Rahmer Profile picture
@brianrahmer
Jan 3, 2018 • 28 tweets • 26 min read • Read on X
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
Expensive health promotion campaigns have failed repeatedly while substantial evidence demonstrates a clear link between poor health and social factors such as unemployment, poverty, lack of opportunity, bad housing and community breakdown. #SDoH
Minimal, negligible and negligent interventions. #SDoH #PEoH #HiAP
“Community health has been a standard element of the public health and health promotion, even political, repertoire for decades now... Community is too important to not fully engage and understand.” #SDoH #PEoH #HiAP #IRoS
"Social & fiscal issues that dominate today’s news may matter as much or even more to our health than any cure medicine can render." #SDoH #PEoH #HiAP #IRoS
Economic Policy as Health Policy.

“Efforts to infuse a culture of health throughout policymaking must broaden their focus on fiscal policies.” #SDoH #HiAP #PEoH
“...in planning for population health, policymakers should focus on fiscal and social policy in addition to health policy, and target investments earlier in the lifespan.” #SDoH #HiAP #PEoH #IRoS
Poverty is one of the most pervasive risk factors underlying poor health, but is rarely targeted to improve health. #SDoH
Better health outcomes in states that enact higher tax credits for the poor, higher minimum wage laws & reject right-to-work laws that limit union power. These policies increase the incomes of low wage and working-class families, not the wealthiest. #SDoH
“Policy-makers must consider adopting more traditional programs of taxation, redistribution and labor market regulation in order to reduce both health inequalities and the underlying social inequalities.” #SDoH #PEoH #HiAP #IRoS
Evaluating Community-Based Health Improvement Programs. @cefry437 et al, 2018.

Disease-specific programs yield modest improvements in the health behaviors targeted, but no overall improvements in health status. #SDoH #PEoH #HiAP #IRoS healthaffairs.org/doi/abs/10.137…
“Many Americans who work don’t make enough money or receive good enough benefits in the jobs that are available to them. A whole bunch of other problems flow from this that relate to family stability, housing, healthcare, childcare & food security.” #SDoH
Increasing Minimum Wages Do More to Reduce Recidivism Than Prisoner Reentry Programs.

“The wages of crime are on average higher than comparable opportunities for low-skilled labor in the legal labor market.” #HiAP #SDoH #PEoH papers.ssrn.com/sol3/papers.cf…
“Our economy segments people into classes brutally & unfairly at birth and then distributes the vast bounty it produces in a harshly unequal manner. Higher growth & a slightly more skilled workforce are not going to change this.” #SDoH #HiAP @jamesykwak baselinescenario.com/2018/02/02/hey…
Higher minimum wage is linked to reductions in mortality rates for diabetes, diseases of the circulatory digestive system, heart attacks & deaths due to external factors. A 10% increase in minimum wage increases life expectancy by 0.44 years. #SDoH #HiAP publichealthpost.org/research/highe…
The consequences of these choices are dire: not only more deaths and illness but also escalating healthcare costs, a sicker workforce, and a less competitive economy. Future generations may pay the greatest price. #SDoH #HiAP #PEoH
Increases in income haven’t nearly kept up with rising costs of living for poorer and many middle-class households. #SDoH #HiAP #PEoH governing.com/topics/urban/g…
Breaking Down the Benefits of Investing in the Opportunity Zones Program. #SDoH #HiAP #PEoH enterprisecommunity.org/blog/2018/02/b…
“Dropping the term safety net is part of the human services groups' broader strategy to get the public and policymakers to think of human services as investments in the community that boost the economy, reduce crime and improve public health.” #SDoH #HiAP governing.com/topics/health-…
“The class gap in mortality will not be closed by tweaking individual tastes.” #SDoH #PEoH #HiAP #IRoS
“Given the ubiquity and influence of economics, this agenda should be supported by the advancement of paradigms that move beyond an exclusive focus on economic growth and which appreciate the importance of collective and societal wellbeing.”
#SDoH #HiAP
“Raising the minimum wage increases earnings growth at the bottom of the distribution, those effects persist & indeed grow in magnitude over several years...there's little indication that people will lose their jobs as a result of the minimum wage” #SDoH census.gov/content/dam/Ce…
“The power corporations wield over labor markets is no longer a theoretical curiosity. We think it’s clear it’s a major source of our economic malaise.” #SDoH #PEoH vox.com/the-big-idea/2…
Policymakers must adopt new approaches to produce good jobs, ensure reinvestment in low-income communities, upgrade the education and skills of an increasingly diverse workforce, and create opportunities for everyone to apply their talents. #SDoH #HiAP
“If there’s a type of economic development program that seems likely to worsen disparities, it’s one that favors capital and technology over labor.” #SDoH #HiAP governing.com/topics/finance…
“If it were true that the economic system we have today can’t even bring our most poverty-stricken workers to a semi-decent standard of living, then why would we defend it? That would be straightforward evidence that we need a better system.” #SDoH theguardian.com/news/2018/apr/…

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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
Dec 28, 2017
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…
Read 154 tweets

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