User:Tyding/sandbox

Sector work: User:Tyding/sector

Area work part 1:User:Tyding/area

Area work part 2: User:Tyding/area2

= Selecting Possible Articles = Sector: Health Leads; Social determinants of health; Social determinants of health in poverty; Diseases of poverty; Diseases of affluence; Health care

Area: San Pablo, California; Contra Costa County, California

= Evaluating two articles[edit] = Sector: Health Leads

The article is for the most part relevant to the topic and of the appropriate tone. However, while the founder was/is heavily involved in the project, much of the article seems to be focused on her, instead of the organization. For example, one line in the article states "The Schwab Foundation for Social Entrepreneurship named Onie one of twenty-four international Social Entrepreneurs of the Year 2013. The award recognizes leadership and innovation, as well as potential for global impact". This is only somewhat relevant, and should be instead placed in either the founder's page, or under another section focused on her. As this is the organization I am working with, learning more about the organization is extremely important. While I had thought that I knew enough about the organization, I realized that I did not know about HealthLeads's funding, and its reach.

For citations, most of the links are active, however, the article uses many sources from the organization's own website. While this is appropriate to a degree, it is good to keep in mind that some of the information does come from a very unbiased source. In addition, much of the information is out of date, and have not been recently updated (the organization does recruit from UC Berkeley, but does not mention this). The article is also missing many important links to the main social issues it is hoping to help with, or details about impact. Lastly, the article's talk page is rather empty.

Area: San Pablo, California

The article is clearly focused on the encyclopedia aspect of the city and lists out its history, demographics, geography, etc. This is appropriate for Wikipedia, as it is a small town, it does not have many famous and Wikipedia entries. However, the article does not at all explain any of the things that make the town unique, or any issues that the town is facing with. The page lacks in detail about recent significant events, and the notable people section seems both underpopulated and unnecessary. As the physical location of my PE is in San Pablo, it is important for me to better understand the individuals with whom I will be working with, as well as the state of the town's available services.

For citations, most of the links are active. No viewpoint really dominates another, as the entire article is only focused on bare facts (many of which come from the US censusthe ), with nothing about culture, controversies, culture, etc. The project is part of two WikiProjects: California and United States - both of which list the page as "C" status - it is significantly lacking in material.

= Beginning Bibliography = I believe that Health Leads (HL) fills a niche in an uniquely professional and personal manner. While many organizations and groups exist that performs a similar task, Health Leads is the only organization, as far as I know, that professionalizes the experience. What HL does is that they connect clients with community resources, and forms a connect between advocate (us) and the client through weekly follow-ups. I think it is important to explore the impact/potential of this kind of service, especially as the Wikipedia page is lacking in details, and this model can be applied in many more locations across the US (Currently only in select areas like East Bay, Boston).

Health Leads Website
The HL website is constantly being updated with up-to-date news, organizational changes, and related industry news. The current Wikipedia page is very out of date, and since HL fills such a unique niche, I also think it is important to link HL to other Wikipedia links.

Dennis Raphael; Beyond policy analysis: the raw politics behind opposition to healthy public policy
I found this piece to be interesting, as it connects many of the dots regarding the social-economic determinants of health. It is actually briefly mentioned/cited in aa Wikipedia article titled “Social Determinants of Health”. However, the section is a stub, and this line of ideology deserves much more research.

Low J. Therault L. (2008) Health promotion policy in Canada: lessons forgotten, lessons still to learned.
An article that combines the themes of GPP 115, and also discussing the effects of social/political movements today. The focus on politics is due to the lack of information on related Wikipedia articles regarding political and social movements and their effects (globally and in the US/Canada)

Low J. Therault L. (2008) Health promotion policy in Canada: lessons forgotten, lessons still to learned.
Similar idea as above, exploring the specifics of policies that was intended to help address social determinants of health. In this article, a specific focus is on Canadian policy.

National Center for Health Statistics (US. (2012). Health, United States, 2011: With special feature on socioeconomic status and health.
This work is a collection of trends and statistics, with one particular one of interest: the special feature on socioeconomic status and health. This provides important contextual information regarding the specific information on the United States, and can fit well into the Health Leads Wikipedia page

Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., & Posner, S. (2005). Socioeconomic status in health research: one size does not fit all
It is also important to keep track of the limitations of each method of research / measurement, and this article provides important context, especially in the sector I am writing about. In addition, it can represent a new meaningful section that mentions socioeconomic status in health, especially with Wikipedia’s identity as an encyclopedia.

= Summarizing and Synthesizing =

Social Determinants of Health
The Power section of the article contains only a very brief overview of the topic and is only about 3 sentences long. The section alludes to public policy as "power", and so the section is supposedly focused on policy. There are a couple challenges to completing the section. The first is that each country has its own set of public policy and current events, and so may be difficult to write comprehensively about multiple countries. However, in my research, I have come across studies and papers that study different countries, and can contribute to this section. My next problem with the stub is its title. I do not really seethe point of having a section titled "power" when a more neutral and accurate title could be "public policy". This is especially true as it seems the title is taken from one author's coining of the term "raw power". To fully expand on this will most likely be a very heavy workload. A final point of concern is that the article Social Determinants of Health in Poverty section has a section on policy. A possible idea would be to expand the section in SDHP instead, and link it into SDH (since SDHP's section is not extensive either).

Diseases of...
Both Diseases of Poverty and Diseases of Affluence both are missing elements for Wikipedia. The first is too slanted towards recent events. While my PE's work is relatively new, it may still be important to understand the historical context of healthcare and poverty. In addition a section titled "Relating to human capabilities" seems to both be relevant to the project, but also the GPP minor. DA seems to be missing citations and is lacking encyclopedia tone. While this seems trivial, some other additions are not. The article is extremely short and it requires expansion. These two articles showcase two sides of HL's goal. First, more obviously, is diseases of poverty. Many individuals are lacking necessities such as food, leading to malnutrition. On the other hand, diseases of affluence is also important to consider. For example, many families are able to afford food, but not physical activities for their children, leading to obesity/diabetes.

Public health programs[edit source]
...

Implementing effective improvement strategies[edit source]
To improve public health, one important strategy is to promote modern medicine and scientific neutrality to drive the public health policy and campaign, which is recommended by Armanda Solorzana, through a case study of the Rockefeller Foundation's hookworm campaign in Mexico in the 1920s. Soloranza argues that public health policy can't concern only politics or economics. Political concerns can lead government officials to hide the real numbers of people affected by disease in their regions, such as upcoming elections. Therefore, scientific neutrality in making public health policy is critical; it can ensure treatment needs are met regardless of political and economic conditions.

The history of public health care clearly shows the global effort to improve health care for all.[citation needed] However, in modern-day medicine, real, measurable change has not been clearly seen, and critics argue that this lack of improvement is due to ineffective methods that are being implemented. As argued by Paul E. Farmer, structural interventions could possibly have a large impact, and yet there are numerous problems as to why this strategy has yet to be incorporated into the health system. One of the main reasons that he suggests could be the fact that physicians are not properly trained to carry out structural interventions, meaning that the ground level health care professionals cannot implement these improvements. While structural interventions can not be the only area for improvement, the lack of coordination between socioeconomic factors and health care for the poor could be counterproductive, and end up causing greater inequity between the health care services received by the rich and by the poor. Unless health care is no longer treated as a commodity, global public health will ultimately not be achieved.[citation needed] This being the case, without changing the way in which health care is delivered to those who have less access to it, the universal goal of public health care cannot be achieved.

Another reason why measurable changes may not be noticed in public health is because agencies themselves may not be measuring their programs' efficacy. Perrault et al. analyzed over 4,000 published objectives from Community Health Improvement Plans (CHIPs) of 280 local accredited and non-accredited public health agencies in the U.S., and found that the majority of objectives - around two-thirds - were focused on achieving agency outputs (e.g., developing communication plans, installing sidewalks, disseminating data to the community). Only about one-third focused on seeking measurable changes in the populations they serve (i.e., changing people's knowledge, attitudes, behaviors). What this research showcases is that if agencies are only focused on accomplishing tasks (i.e., outputs) and do not have a focus on measuring actual changes in their populations with the activities they perform, it should not be surprising when measurable changes are not reported. Perrault et al. advocate for public health agencies to work with those in the discipline of Health Communication to craft objectives that are measurable outcomes, and to assist agencies in developing tools and methods to be able to track more proximal changes in their target populations (e.g., knowledge and attitude shifts) that may be influenced by the activities the agencies are performing.

One more recent addition to public health improvement strategies is the focus on the Social determinants of health.

EDIT DRAFT: Economic Theory in SDoH

 * 1) I feel like the article mentions very briefly potential interventions, but does not go into depth. Instead, it gives one example and nothing more. In addition, it is challenging to measure the value of interventions, and this is a key aspect of SDoH.

Interventions

Three common interventions for improving SDOH outcomes as identified by the WHO are education, social security and urban development. Due to the nature of the interventions and their impact, and their disproportionally heavy impact on children, evaluation of interventions has been difficult.

Education: Many scientific studies have been conducted and strongly suggests that increased quantity and quality of education leads to benefits to both the individual and society. Health and economic outcome improvements can be seen in obesity, blood pressure, crime, and market participation trends. Examples of interventions include decreasing size of classes and providing additional resources to low-income school districts. However, there is currently insufficient evidence to support education as an SDOH intervention with a cost-benefit analysis.

Social Security: Interventions such as “health-related cash transfers”, maternal education, and nutrition-based social protections have been shown to have a positive impact on health outcomes. However, the full economic costs and impacts generated of social security interventions are difficult to evaluate.

Urban Development: Urban development interventions include a wide variety of potential targets such as housing, transportation, and infrastructure improvements. The health benefits is clearly evident, especially with housing improvements (smoke alarm installation, concrete flooring) on children. There is a fair amount of evidence to show that urban development interventions have a net positive effect on economic benefit, whereas there is currently not enough evidence affordable housing programs are effective. In addition, transport-specific interventions have been shown be economically beneficial for developed countries.

Challenges of measuring value of interventions

Many economic studies have been conducted to measure the effectiveness and value of SDOH interventions but is unable to accurately reflect effects on public health due to the multi-faceted nature of the topic. While neither cost-effectiveness nor cost-utility analysis are able to be used on SDOH interventions, cost-benefit analysis is able to better capture the effects of an intervention on multiple sectors of the economy. For example, tobacco interventions have shown to decrease tobacco use, but also prolong lifespans, increasing lifetime healthcare costs and is therefore marked as a failed intervention by cost-effectiveness, but not cost-benefit. Another issue with research in this area is that most of current scientific papers focus on rich, developed countries, and there is a significant lack of work done on developing countries.