RISE looks at recent headlines concerning social determinants of health (SDoH).
Racial disparities revealed in health care spending
Health care spending in the U.S. has been disproportionately spent on white individuals, according to researchers from the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine, who recently analyzed health care spending by race and ethnicity groups from 2002 to 2016.
The study, which was published this week by JAMA Network, explored survey data captured from 7.3 million health system visits, admissions, or prescriptions in the U.S., which was combined with population data and health spending estimates. Among the findings:
- White Americans received 72 percent of health care spending, but they only account for 61 percent of the country’s population
- Hispanic and Asian, Native Hawaiin, and Pacific Islander individuals received significantly less spending than their population percentage
- Although health care spending for Black Americans was roughly proportionate to their population, it was primarily spent on inpatient and emergency department care
“This study provides a clear picture of who is benefiting from and who is being left behind in our health care system,” Joseph L. Dieleman, Ph.D., associate professor in the department of health metric sciences at the University of Washington and lead author of the study, said in a statement. “Measuring disparities in health care spending and use not only helps us understand the magnitude of inequities, but also provides valuable insights for policymakers to address their underlying causes.”
Study shows staggering rates of depression and anxiety in children amid pandemic
Prevalence rates of depression and anxiety in children have doubled during the COVID-19 pandemic, according to a recent study published by JAMA Pediatrics. Researchers estimate that one in four children globally are currently experiencing clinical signs of depression and one in five are experiencing clinical signs of anxiety, both of which are double the pre-pandemic rates.
Researchers attribute the increase in depression and anxiety among children to the sudden loss of peer interactions, social isolation, and loss of contact with “buffering supports,” such as teachers and coaches. School closures limited mental health resources as well since 80 percent of children rely on school-based services for mental health needs, noted researchers.
As the first year of the pandemic progressed, so did the prevalence of depression and anxiety symptoms among children, particularly girls. Researchers linked the corresponding progression to the ongoing social isolation, family financial stress, missed milestones, and school disruptions.
To lessen the impacts of COVID-19, researchers recommend the implementation of daily routines for children around schoolwork, sleep, screen time, and physical activity.
Policy intervention recommendations to address SDoH and promote health equity
In a recent issue report aimed to encourage policy decisions and strategies targeted to improve health outcomes, reduce costs, and promote health equity, Trust for America’s Health (TFAH), a non-profit advocacy organization, has highlighted a variety of policy actions that can address SDoH and longstanding health inequities. The policy recommendations relate to health care access, economic mobility, affordable housing, safe and health learning environments for children, and health-promoting excise taxes.
“The COVID-19 pandemic put a spotlight on the role that social and economic conditions play in health and gives policymakers an opportunity to build an improved social supports and public health system,” said TFAH President and CEO J. Nadine Gracia, M.D., MSCE, in an announcement. “Focusing solely on individual behavior will not solve America’s health crisis. Building healthy and thriving communities and advancing health equity require improving the social and economic conditions that shape health. Only then will everyone have a fair and just opportunity to enjoy optimal health.”
Here are five policy recommendations from the report:
- Adopt Medicaid expansion to reduce the number of uninsured individuals, improve access to quality health care, reduce mortality, and reduce total spending.
- Expand the earned income tax credit to better support working families, improve maternal and child health, increase employment, and reduce poverty.
- Expand the low-income housing tax credit program to increase discretionary income for low-income families, increase access to affordable housing, and promote economic growth.
- Increase access to high-quality early childhood education programs to promote healthy development, improve cognitive outcomes and academic success, improve health, and reduce additional education spending.
- Tax products such as tobacco, alcohol, and sugar-sweetened beverages to promote healthy choices, reduce health care costs, and prevent obesity.
To read the full list of policy recommendations, click here.