Big government — or good neighbors — can improve people’s health

Big government — or good neighbors — can improve people’s health.

Study explores connection between ideology, social capital and health

Lincoln, Neb., March 20, 2014 – The nation’s left-leaning citizens might be pleased by the findings of a new University of Nebraska study that finds those who live in liberal states tend to be healthier.

But conservatives could also take satisfaction in the same study’s conclusion that strong communities also foster better health.

“Some people might like the argument that liberal government automatically leads to healthier people, because it supports their worldview,” said Mitchel Herian, a faculty fellow with the university’s Public Policy Center and lead researcher on the new study. “But in the absence of a liberal government, you also see better levels of health if you have a strong community.”

The study, published in the March issue of the journal Social Science and Medicine, combined data from the 2010 Behavioral Risk Factor Surveillance System to measure health, a 2009 Gallup Healthways Survey to measure levels of social trust and a 2010 index that rates liberalism in state government. In all, the study involved data collected from more than 450,000 people from across the country.

It found that states with high levels of liberalism and those with high levels of social trust have higher levels of health and well-being.

The two factors – liberalism and social trust – are not interchangeable. People who live in a California city might have liberal political beliefs but mistrust their neighbors, Herian said, while those who live in a small Texas town might mistrust government but count on their neighbors.

To measure a state’s social capital, Herian and his colleagues used data from a survey that asked “If you lost a wallet or purse that contained $200 and it was found by a neighbor, do you think it would be returned with the money in it or not?”

To assess states’ political profiles, the study used an index that scores each of the 50 states on their relative liberalism vs. conservatism. The index is based upon factors such as interest group ratings of congressional members, voting records and election results in congressional races. It is designed not only to assess partisanship, but the extent to which politicians favor liberal social policy.

Health and well-being were measured with questions from the behavior risk survey that asked respondents to rate their health and to report how frequently poor physical or mental health prevents them from carrying out daily activities. The researchers also took smoking habits and body mass index into consideration.

Herian authored the study with psychologists Louis Tay of Purdue University, Ed Diener of the University of Illinois and UNL graduate student Joseph A. Hamm.

“Liberals argue for government programs and conservatives argue for individual responsibility,” Diener said. “When government programs are in place, people tend to be healthier. But when government programs are weaker, a person with lots of close ties and social capital can still be healthy. Their wife can get them to exercise, their friends can help them not drink too much, and their support for each other may directly affect their health. Loneliness is bad for health.”

The researchers said the study has implications for health policy at the state and local levels. Herian, who has studied how social trust influences public policy, said he expects to do more research on how to measure social trust.

Tay said the study shows two pathways to improving people’s health: Strong communities can provide good health outcomes, but government social programs also have a strong connection to good health and could be necessary to serve more fragmented and isolated communities.

Diener said the research demonstrates that good health is not just a matter of individuals “doing the right thing” like quitting smoking, exercising more and losing excess weight.

“Social factors have an influence, too,” he said. “It might be government programs, or it might be ‘social capital’ – having supportive others around us – that can influence our health beyond just each of us doing the right things.”

 

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Car

AHRQ’s Health Care Innovations Exchange Focuses on Clinical-Community Linkages to Improve Chronic Disease Care

From a recent email update rec’d from AHRQ (US Agency for Healthcare Research and Quality)

The July 3 issue of AHRQ’s Health Care Innovations Exchange features two profiles of partnerships between clinical practices and community organizations that leverage health provider teams and lay health advisors to improve the management of chronic diseases. One profile describes a public-private initiative that worked with community health teams to improve the delivery of preventive, health maintenance, and chronic care services in Vermont. The pilot program included incentive payments to providers who met National Committee for Quality Assurance-determined care standards, access to an insurer-funded team of community-based health providers, health information incorporated into a Web-based clinical tracking system, and interfaces with other State care coordination initiatives. Over a 4-year period, the pilot program experienced a 6 percent decrease in inpatient admissions and a 10 percent decrease in emergency department visits among participating practices. Select to read more profiles related to clinical-community linkages, including innovations and tools, on the Health Care Innovations Exchange Web site, which contains more than 700 searchable innovations and 1,500 QualityTools.

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• Tools Help Foster Communication Between Patients and Clinicians (thielst.typepad.com)

The Guide to Community Preventive Services: What Works to Promote Health

The Guide to Community Preventive Services  is a great resource for what methods and interventions work well to improve public health. It is geared towards public health officials, researchers, and policy makers. However, it is also a good aid for anyone looking for the best way(s) to address issues touching family members and friends. The information can be used to promote or advocate for changes in policies and laws at local or national levels. They can be used to positively influence changes for the better in schools, workplaces, public health departments, and more.

A good way to start is through the Topics link at the top of the page. It includes links to issues as asthma, cancer, diabetes, nutrition, obesity, vaccines, and violence. Each topic includes links to more information on the topic and related topics.
Many topics have summaries of recommendations and findings. For example the topic Diabetes includes recommendations for certain disease management programs but insufficient evidence for self management programs in school settings or worksites.

All information on the interventions for a specific topic (as violence, diabetes, alcoholism) is carefully reviewed through a standardized step by step process.  systematic reviews. Each reviews includes summarized results of all related evidence.  These unbiased evidence-based reviews are also called systematic reviews.
[Click here for a good explanation of the systematic review process]

Each topic in this community guide answer questions  such as: c

• What interventions have and have not worked?
• In which populations and settings has the intervention worked or not worked?
• What might the intervention cost? What should I expect for my investment?
• Does the intervention lead to any other benefits or harms?
• What interventions need more research before we know if they work or not?

Click on these tabs at the top of the  home page for additional information

• Use the community guide for an overview,  listing of topics, and subscribing to email updates
• Methods for explanations of systematic and economic reviews
• Resources as
  • Publications by and about this task force
  • Slides to help tell others about this guide
  • Outreach materials as a flyer, a bookmark and a table tent
  • A glossary
  • News and a comprehensive About Us sections

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• Behavioural interventions for the prevention of sexually transmitted infections in young people aged 13 – 19 years: a systematic review (testcas.wordpress.com)
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• Systematic review / synthesis of qualitative evidence – issues (phtwitjc.wordpress.com)
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• Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace (jflahiff.wordpress.com)
• PubMed Health – A Growing Resource for Clinical Effectiveness Information (jflahiff.wordpress.com)
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• Cochrane Reviews – A Great Source for Sound Medical Evidence (jflahiff.wordpress.com)

New community health approach aims to combats chronic disease, empower patients, reduces costs

From the 8 February 2012 Eureka News Alert

New community health approach aims to combats chronic disease, empower patients, reduces costs

Value of Accountable Care Community approach to public health promotion and disease prevention outlined in new paper released today

AKRON, Ohio, February 8, 2012 – A new community-wide collaboration to reduce the impact of chronic disease and empower patients is generating impressive early results, leaders of the Accountable Care Community (ACC) initiative said today. The Akron-based Austen BioInnovation Institute in Akron (ABIA) is leading the initiative with its founding institutional members and more than 60 public and private community partners.

The groundbreaking effort supported by the Centers for Disease Control and Prevention unites medical, public health and social science professions, nonprofits and faith-based and community organizations for an “all-hands-on-deck” approach to public health. Eventually, communities across the country will be able to apply this new model toward public health, reducing the tremendous negative impact chronic disease has on their economies, said Dr. Janine Janosky, head of ABIA’s Center for Community Health Improvement, who is leading the effort described in a white paper released today.

The news comes just weeks after an Institute of Medicine report called for a new public health approach based on “enhanced collaboration among the public health, health care and community non-healthcare sectors” to address the challenges of chronic disease. The World Health Organization refers to the growing impact of chronic disease as “a global epidemic” reaching crisis levels. The Robert Wood Johnson Foundation estimates that by 2030, half the U.S. population will have at least one chronic condition.

The ABIA, along with national experts and more than 60 Akron organizations, have been collaborating for more than a year on a new, integrated, and measurable strategy to community health that could be replicated in other U.S. communities. The ACC approach detailed in the report “Healthier by Design: Accountable Care Community” utilizes a unique “impact equation” that measures the benefits of a seamless approach to community health, including metrics for a patient empowerment and market value of health, said Dr. Frank L. Douglas, ABIA president and chief executive officer.

“The amount spent on healthcare and health initiatives in the United States should translate into good health for the community and its residents. Unfortunately, America’s public health continues to lag behind other nations. Further, we are now in an era of debate about how to reverse the unsustainable cost trends and improve the health outcomes and quality of life for our fellow man,” Dr. Douglas said. “The development of this inventive Accountable Care Community model, which not only speaks of the need for collaboration but actually enables all parties to be on the same page with an integrated, measurable strategy, promises to improve the health of millions of patients.”

In Akron, the ACC approach uniquely aligns public, private and philanthropic resources in a coordinated fight to improve community health by identifying and closing gaps in health education, access and delivery. The group’s initial pilot project focused on diabetes self-management. Ultimately, participants changed their behaviors and took increased control over their disease. Significant results included decreases in blood sugar and bad cholesterol levels, weight loss, decreased body mass, and a decline in emergency room visits. An additional program demonstrated nearly a total of $225,000 of cost savings or cost avoidance for local healthcare institutions through the use of volunteers and community services to monitor and serve low-income, medically underserved patients with diabetes….

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