social determinants of health, health disparities, health equity, health in all policies, policymakers, public policy


BACKGROUND: Policies shape our society and influence our health. Poor social policies and bad politics create a collective social milieu that result in health inequities. Closing the health gap in our communities will require tackling these root causes. But how are U.S. policymakers addressing the social conditions that negatively influence health? The purpose of this qualitative systematic review is to identify the social determinants of health perceived as legislative priorities by U.S. policymakers and the factors that facilitate or/ hinder their intent to act on the social determinants of health.

METHODS: We searched 30 journal and news media databases and retrieved a total of 1,832 unique newspaper, magazine, and journal articles published between January 2000 and July 2016. Of these, 191 articles met our inclusion criteria for qualitative analysis. We recorded policymaker demographics, the social determinants addressed by these policymakers, and any legislative or policy action taken.

RESULTS: Political attention focused mainly on healthcare access, chronic diseases, and the Affordable Care Act. The literature discussed the need for policymakers to act on the social determinants but lacked empirical studies on effective policy strategies, such as a health in all policies approach. Awareness and political party/constituency support promoted action on the social determinants.

CONCLUSIONS: Because of the complex and protracted nature of social factors, it is less likely to obtain results within a policymaker's tenure in office. This can weaken the political will to act on the social determinants responsible for inequities in health. Policy agenda setting and action on social determinants will require defining the short- and long-term facets of complex social problems that are significant yet actionable and achievable over a political timeline. Understanding policymakers’ perspectives and the political will on public health legislation are crucial to improving population health.

Original Publication Citation

Novilla, M. L. B., Goates, M. C., Galvao, L. A., & Quintana, N. M. (2018, March). Navigating the politics of health: A systematic review of U.S. policymakers’ views on the social determinants of health, health disparities, health equity, and health in all policies. Presented at the Roseman University Research Symposium, South Jordan, UT.

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Health Science

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Associate Professor

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