Social Epidemiology: Social Determinants of Health in the United States: Are We Losing Ground?

Abstract

The United States ranks in the lower tiers of OECD countries in life expectancy, and recent studies indicate that socioeconomic inequalities in health have been widening in the past decades. Over this period, many rigorous longitudinal studies have identified important social, behavioral, and environmental conditions that might reduce health disparities if we could design effective interventions and make specific policy changes to modify them. Often, however, neither our policy changes nor our interventions are as effective as we hoped they would be on the basis of findings from observational studies. Reviewed here are issues related to causal inference and potential explanations for the discrepancy between observational and experimental studies. We conclude that more attention needs to be devoted to (a) identifying the correct etiologic period within a life-course perspective and (b) understanding the dynamic interplay between interventions and the social, economic, and environmental contexts in which interventions are delivered.

Influences of income and employment on psychological distress and depression treatment in Japanese adults

“…Social epidemiology is the branch of epidemiology that studies the social distribution and social determinants of states of health [7]. One major aspect of social epidemiology is work and health, focusing on health inequalities resulting from specific occupations and the health effects of working conditions and job loss [8].…”

Eating together as a social network intervention for people with mild intellectual disabilities: a theory-based evaluation

“…The Communal Table to some extent created a nascent social network of support and familiarity, especially for those participants who lacked strong ties, allowing them to temporarily escape from their loneliness. Such a temporary relief may serve as a valuable starting point for participants in a strengthened version of the Communal Table to work on building the strong ties they may require to also improve their often poor mental health and quality of life (Berkman, 2009; Howarth et al, 2016; Rook, 1984). …”

“…Deinstitutionalization and extramuralization can be viewed as empowering for vulnerable groups, but can result in social exclusion and feelings of loneliness as well (Verplanke & Duyvendak, 2009). Larger social networks and increased societal participation should lead to social inclusion, a higher quality of life and increased mental well-being for people with MID (Berkman, 2009; Duvdevany & Arar, 2004; Schalock, 2004). …”

To Reduce Urban Disparities in Health, Strengthen and Enforce Equitably Environmental and Consumer Laws

“…1 Economic trends such as increasing poverty and unemployment rates, dismantlement of safety net programs, the decline of wellpaying US manufacturing jobs that traditionally provided health care benefits, and the shift of health care costs from employers to workers suggest that these disparities will continue to grow.…”

“…Common explanations for disparities in health include differences in genetic predisposition, access to health care, socioeconomic and behavioral characteristics, cultural preferences, exposure to environmental hazards, or some combination of these. [1][2][3][4][5][6]13,14 At the present, we can do little to modify the effects of genetics on human health, 15 and modifying individual behaviors and cultural practices sufficiently to influence population health has proven to be difficult. 16 Therefore, progress in eliminating disparities in health requires that we look upstream to social and environmental factors that are amenable to intervention through public policies.…”