4

Intersectoral Action on Health

Live in fragments no longer. Only connect….

—E.M. Forster, (1910)

The health of a nation is shaped by more than medical care, or by the choices that individuals make to maintain their health, such as quitting cigarette smoking or controlling diabetes. The major contributors to disease—risk factors under the control of individuals (e.g., obesity, tobacco use), exposure to a hazardous environment, or inadequate health care—are themselves influenced by circumstances that are nominally outside the health domain, such as education, income, and the infrastructure and environment that exist in workplaces, schools, neighborhoods, and communities. In this chapter, the committee discusses the implications of the social determinants of health for the actions of various stakeholders, with a focus on non-health policies that affect population health (see Box 4-1 for a few examples). Here, the committee reviews the frameworks and models that exist for the engagement of non-health actors in considering the health outcomes of their policies, and even, perhaps, in improving their positive contributions to achieving health objective.

The literature linking population health outcomes with these antecedents (i.e., the determinants of health) is robust and includes decades of work by Marmot, Wilkinson, and colleagues (Marmot et al., 1991, 1997; The Marmot Review, 2010), including the World Health Organization Commission on the Social Determinants of Health, Adler and the MacArthur Research Network on Health and socioeconomic status (SES), and many others.

The health significance of “non-health” factors is often overlooked. Education is a prime example. People with a college degree are one third less likely to smoke than those who have not completed high school. Miech et al.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page 73
4 Intersectoral Action on Health Live in fragments no longer. Only connect.... —E.M. Forster, (1910) The health of a nation is shaped by more than medical care, or by the choices that individuals make to maintain their health, such as quit- ting cigarette smoking or controlling diabetes. The major contributors to disease—risk factors under the control of individuals (e.g., obesity, tobacco use), exposure to a hazardous environment, or inadequate health care—are themselves influenced by circumstances that are nominally outside the health domain, such as education, income, and the infrastructure and environment that exist in workplaces, schools, neighborhoods, and communities. In this chapter, the committee discusses the implications of the social determinants of health for the actions of various stakeholders, with a focus on non-health policies that affect population health (see Box 4-1 for a few examples). Here, the committee reviews the frameworks and models that exist for the engagement of non-health actors in considering the health outcomes of their policies, and even, perhaps, in improving their positive contributions to achieving health objective. The literature linking population health outcomes with these anteced- ents (i.e., the determinants of health) is robust and includes decades of work by Marmot, Wilkinson, and colleagues (Marmot et al., 1991, 1997; The Marmot Review, 2010), including the World Health Organization Com- mission on the Social Determinants of Health, Adler and the MacArthur Research Network on Health and socioeconomic status (SES), and many others. The health significance of “non-health” factors is often overlooked. Education is a prime example. People with a college degree are one third less likely to smoke than those who have not completed high school. Miech et al. 73

OCR for page 73
74 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY BOX 4-1 Examples of Non-Health Policies with Health Effects Federal agricultural subsidies are enacted with agricultural, economic, and trade objectives in mind, but their effects on health are significant. Similarly, trans- portation planning may have as a primary objective the optimal way to facilitate goods movement or to commute between home and work, but related issues must be considered, including local economic development that may be enhanced or impaired by public transportation, road design and other physical features (access to public transportation); community functioning (e.g., when a busy highway di- vides a neighborhood); and health, which may be positively or negatively impacted depending on the extent to which transportation planning considers whether to encourage and facilitate pedestrian and bicycle traffic. (2009) reported that adults ages 40 to 64 with only a high school education are more than three times more likely to die from diabetes than those who have graduated from college. Educational attainment determines whether individuals can obtain good jobs and whether they acquire the knowledge, health literacy, and other tools needed to make informed choices about their health. Income is another important factor. Certainly, low-income individuals are less likely to have health insurance, but income also affects health by enabling families to live in healthy neighborhoods and housing and to af- ford nutritious groceries, fitness clubs, copayments for doctor’s visits, and prescription medications. Income is a health determinant in all social classes, not just for the poor. Americans with incomes that were 201 to 400 percent of the poverty level had shorter lives and a greater likelihood of fair or poor health than were those with incomes more than 400 percent of the poverty level (Braveman and Egerter, 2008). Woolf and colleagues (2007) reported that 25 percent of all deaths in Virginia would have been averted if the entire state experienced the mortality rate of those living in the five most affluent counties and cities. Place affects health—neighborhood and community environments exert their own health influences, independent of the risk factors associated with individuals and households. Research links social and economic features of neighborhoods “with mortality, general health status, disability, birth outcomes, chronic conditions, health behaviors and other risk factors for chronic disease, as well as with mental health, injuries, violence and other important health indicators” (Cubbin et al., 2008). People living in poor neighborhoods with inadequate housing, high levels of crime, high density of alcohol outlets, and a scarcity of fresh food retailers are more likely to

OCR for page 73
75 INTERSECTORAL ACTION ON HEALTH experience a range of health problems. These problems are related to obe- sity, physiologic consequences of chronic exposure to stress, living in an environment lacking in social capital, and other factors. PATHWAYS BETWEEN HEALTH AND ITS DETERMINANTS “Upstream” or distal determinants of health—conditions that influ- ence the more proximal factors such as blood pressure and health care services—include individual, household, and area-based factors. Examples of individual factors include a person’s race or ethnicity, which cannot be changed, and modifiable factors such as behavioral choices and educa- tional attainment.1 Household-level health factors define a family’s income level, health insurance coverage, and housing conditions. Area-based or place-based conditions affect individuals and households throughout the neighborhood and community and are characteristics of a geographic area, such as a Census tract or block. Examples include ambient air pollution, crime rates, social cohesion, walkways and green space, the quality of local schools, health care facilities, access to healthful foods, the density of fast- food restaurants, marketing of tobacco and liquor, and access to affordable public transportation. Individual, household, and environmental factors form a complex causal web that complicates observed associations between health outcomes and any one factor in isolation. For example, in the arena of environmental factors, substandard housing is a known associate of poor health. How- ever conditions other than housing itself (e.g., pests, proximity to sources of pollution, unsafe streets, unhealthful occupations, lack of medical care) also explain occupants’ greater experience of asthma, mental illness, and malnutrition (e.g., examples of research on the links between housing and health can be found in Braveman et al., 2010; Britten, 1938; Dalla Valle, 1937; EPA, 2011; Erickson and Marks, 2011; Krieger and Higgins, 2002). Confounding relationships between interrelated causal factors make it important to determine the degree to which socioeconomic and contextual conditions are markers for other factors that play equally important causal roles (for an illustration of the multiple pathways linking education and health, see Braveman et al., 2011a). For example, the evidence linking in- come and health is extensive and goes back decades and even centuries, but questions about causality remain pervasive and further research is needed to disentangle the complexity of the pathways linking the two (see, for ex- ample, Chandra and Vogl, 2010; Muennig, 2008). 1 There are also levels of modifiability, including the degree of difficulty, time requirements, and the importance of a given factor compared to others potentially implicated in causing the health outcome of concern.

OCR for page 73
76 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY THE ROLE OF POLICY AS A DETERMINANT OF HEALTH Although many socioeconomic and environmental factors affect health, only some are under the personal control of individuals and families. People can make the effort to complete high school, pursue higher education, make informed choices to improve their health, and obtain a job that is good for health—a job that promotes wellness, limits exposure to occupational stress or injuries, offers health insurance benefits, and provides an income that makes health care, healthy behaviors, and healthy neighborhoods afford- able. However, the success of these efforts depends in part on factors outside the control of individuals and families. The quality of schools, the strength of the job market, worksite safety, and the healthfulness of neighborhoods and communities are determined by decisions taken by policymakers outside the family and the health sector (Adler et al., 2007; Commission on Social Determinants of Health, 2008; Lovasi et al., 2009; Marmot and Bell, 2011; Marmot and Wilkinson, 1999; Marmot et al., 1997; The Marmot Review, 2010). In corporate boardrooms, legislatures, and the executive branches of government, decisions that ultimately affect the public’s health emerge from policies that few view as health decisions. Initiatives to promote jobs, corporate growth, transportation infrastructure, and community develop- ment are deliberated by officials, executives, and other decision-makers who often are unaware of or overlook the connection to health. School boards, educational agencies, and ballot initiatives determine funding for local schools and set policies that affect children’s learning, educational at- tainment, physical activity, and diet. The ability of adults to find work, a stable income, and good health insurance benefits is shaped by legislation, labor policy, economic strategy, the tax code, and deals negotiated between managers and unions. The healthfulness of neighborhoods and communities is shaped by the decisions of private developers, local officials, businesses, and voters. Fed- eral tax policy, corporate competition, zoning regulations, advertising, and the local economy influence whether residents have access to supermarkets and parks or are exposed to air and water pollution, fast foods, liquor stores, and tobacco advertising. Land use decisions determine whether the built environment is conducive to physical activity, for example, whether builders add sidewalks, bicycle paths, and greenways (e.g., paths or trails for recreation, pedestrians, and bicycles) to roadway construction projects (American Planning Association, 2002; Cubbin et al., 2008). Decisions to forego economic development and community investment set the path for neighborhood deterioration and the emergence of urban decay, unhealthy housing, pollution, violent crime, and the departure of businesses, jobs, schoolteachers, and quality medical care—and their attendant health ben- efits—to more attractive neighborhoods (Kelly, 2004). Decisions about

OCR for page 73
77 INTERSECTORAL ACTION ON HEALTH public transit serve not only to limit exposure to automobile emissions, but also to help individuals reach jobs with health benefits, medical care, educational opportunities for themselves and their families, and nutritious groceries (Cubbin et al., 2008). Specific policy examples of these connections between non-health poli- cies and health effects are increasing. For example, in agricultural policy, evidence shows that corn subsidies may contribute to unhealthful American diets (see Alstona et al., 2008; Harvie and Wise, 2009; Wallinga, 2010), which in turn contribute to obesity, diabetes and cardiovascular disease. Other countries have shifted government agricultural subsidies to gradually modify industry practices and to support the cultivation and increase the af- fordability of more healthful crops, such as vegetables and fruits (Capewell and Lloyd-Jones, 2010). Urban planning provides another example. Free- ways that divide neighborhoods to facilitate commuter traffic can harm health, quality of life, and community well-being (Wier et al., 2009). One group of researchers summarized the recent efforts directed at freeway “deconstruction” as reflective of urban and land use planning priorities that are “shifting away from designing cities to enhance mobility,” “toward promoting economic and environmental sustainability, livability, and social equity” (Cevero et al., 2009, pp. 31, 32). In its information gathering, the committee learned about New York City’s FRESH program that represents a collaboration among the health and planning agencies and the local economic development corporation and provides incentives to bring grocery stores to areas that lack access to fresh fruits and vegetables (Bryon, 2010; IOM, 2010). In San Francisco, the Federal Reserve Bank has been exploring opportunities for cross-sectoral partnership between community development and health (see, for example, Federal Reserve Bank of San Francisco, 2010). Other examples of links between non-health policies and health outcomes have been building over decades of experience and research. These include a rich evidence base that has demonstrated that the poor health outcomes in adulthood that is associ- ated with disadvantage in childhood can be effectively prevented by policy interventions as varied as home health visiting programs, early stimulation in child care programs, and preschool settings (i.e., Early Head Start and Head Start) (Adler and Stewart, 2010; Braveman et al., 2010; Evans and Kim, 2010; Kawachi et al., 2010). In 2009, the National Center for Healthy Housing conducted a review of the evidence of the health effects of housing policies (Jacobs and Baeder, 2009). They found evidence for the use of several housing interventions, including rental housing vouchers, structural modifications (e.g., asthma interventions, pest management, and radon mitigation), as well as smok- ing bans and lead hazard control. In 2010, the Urban Institute published findings from their evaluation of the Chicago Family Case Management

OCR for page 73
78 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY Demonstration, which is an “effort to test the feasibility of using public and assisted housing as a platform for providing services to vulnerable families” (The Urban Institute, 2010). Participants in the program reported gains in employment, housing, neighborhood conditions, and health with reduced fear and anxiety (Popkin et al., 2010; The Urban Institute, 2010). Altering the Built/Physical Environment The notion that communities can shape the environment to be healthier or more health supportive is a fundamental belief underlying this report. A wide range of policy tools (included among the tools described in Chapter 3) are available to address features of the built environment, and several jurisdictions across the country have successfully experimented with land use interventions, including in the areas of zoning and transportation. This type of tools, however, differs somewhat from many others listed earlier because they go beyond the purview of the public health agency and require involvement and leadership from other parts of government and from the private sector. The boundaries between health and non-health policies, such as zon- ing, are not always sharply delineated. For example, in recent years, zoning decisions have increasingly incorporated health as a specific objective, so- called “health zoning” (Abdollah, 2007; Chen and Florax, 2010; Mair et al., 2005). Local governments have banned gun dealers in residential areas to reduce crime and violence in communities, and have made zoning deci- sions to limit the density or avoid school proximity to alcohol sources and more recently, fast-food outlets (Chen and Florax, 2010; Gostin, 2010). In some cases, urban planners, transportation officials, and other non-health professionals have been the ones to initiate activities to redesign the built environment in ways that promote and support healthier choices. The built environment is strongly linked with several types of health outcomes in the population (Bauman and Bull, 2007; Brownson et al., 2006; Communities Count, 2008; TRB and IOM, 2005). Obesity is perhaps the most prominent current concern, and is related not only to the food one consumes and one’s level of physical activity, but to environmental features such as • a community’s zoning laws that dictate the density of fast-food outlets, and incentivize (or not) the introduction of supermarkets and other fresh-food outlets (California Center for Public Health Advocacy et al., 2008; Diller and Graff, 2011); • t ransportation plans and laws that encourage (or not) pedestrian and bicycle use rather than motor vehicle use (Brownson et al., 2005; McCann et al., 2009);

OCR for page 73
79 INTERSECTORAL ACTION ON HEALTH • p lanning guidelines that expand green and recreational spaces, and school requirements that allow community use of athletic fields (Garcia and White, 2006; Lovasi et al., 2009); and • a community’s ability to set aside and use land for community gar- dens (NPLAN, 2010; Twiss et al., 2003). Laws and other types of public policy can change these and other aspects of physical or built environment. THE “HEALTH IN ALL POLICIES” MOVEMENT Interest has been growing both in the United States and abroad, in “Health In All Policies” (HIAP), an approach to policymaking in which de- cision-makers outside the health sector routinely consider health outcomes: benefits, harms, and health-related costs. Kickbush and Buckett (2010, p. 12) define HIAP as “public service agencies working across portfolio bound- aries to achieve a shared goal and an integrated government response to particular issues. Approaches can be formal or informal, and can focus on policy development, program management and service delivery.” Although the HIAP concept emerged in connection with government organizations, its meaning has been extended to include private and non-profit policies as well. Examples of public health-relevant policies in the private and non- profit sectors include employer policies and practices (e.g., in response to safety requirements imposed by insurers), building standards that exceed government requirements (such as LEED2 “green” building certification), and principles for sustainable investment (e.g., yielding financial, social, and environmental returns3). Rationale Most decision-makers who set policies on housing, agricultural crop in- centives, or highway construction do not usually consider the public health dimensions, in part because they have not had traditional, or statutory, re- sponsibility for those areas. Also, health entities in the government, private, and not-for-profit sectors are similarly unlikely to connect or collaborate with those who may be considered stakeholders in the public’s health. These failures to connect have consequences for all involved. Too often, propo- nents of a policy overlook potential health benefits in making their case or in calculating the return on investment to argue the value proposition. Conversely, advocates of a policy do not always consider the potential 2 Originally denoted “Leadership in Energy and Environmental Design.” 3 See, for example, Emerson et al. (2008).

OCR for page 73
80 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY harms to public health, and resulting costs, or how those harms could be mitigated. Overlooking health seems incompatible with good policymaking, not only because it creates an incomplete picture of the full outcomes of a proposed course of action, but also because it can undermine the ability to coordinate efforts across sectors to address important public health and economic priorities. For example, a coordinated approach to the obesity epidemic—a health outcome that imposes great cost on the economy (CDC, 2010; Wang et al., 2008; Wolf and Colditz, 1998) and on employers (Fin- kelstein et al., 2005; Goetzel et al., 1998; Schmier et al., 2006), and may present a risk for developing other poor health outcomes such as diabetes and heart disease—requires synergistic changes in schools, workplaces, ad- vertising, the food industry, restaurants, parks, public transportation, tax policy, and clinical care. A coordinated approach to this problem therefore requires policymakers in each of these sectors to consider their respective role in addressing obesity and how best to harmonize their efforts with other sectors. Working across sectors can improve effectiveness in addressing pub - lic health problems by tackling root causes that are outside the traditional health sector. It could also maximize the use of existing government, insti- tutional, and policy resources by promoting synergy, identifying economies of scale, and reducing duplication of effort (Baxter, 2010). Adopting a HIAP approach could cost little or nothing in many areas of local government. For example, in transportation, land use, or zoning decisions, some modifica- tions that influence health may have minor or no budgetary implications for the implementing agencies (Boufford, 2011, offers the example of using regularly scheduled bus stop renovations to make them more accessible to older adults, and thus provide support for healthier aging). Cross-governmental collaboration is hardly a novel notion for public health agencies. Those capacities were evident after September 11, 2001, when bioterrorism preparedness planning brought public health practi- tioners into closer discussions with fire, law enforcement, and emergency management communities. A need for broader collaboration to address the rising prevalence of chronic disease has strengthened the imperative for coordinated efforts across the public and private sector. Ultimately, the health of a nation is instrumental in its economic strength and competitiveness. Businesses can rise and fall on the strength of their employees’ physical and mental health, which influence levels of productiv- ity and, ultimately, the economic outlook of employers (World Economic Forum, 2008). The United States’ lower life expectancy and lower health- related quality of life has implications for all sectors in society in terms of opportunity and other costs (financial, human potential, social, and other). Reform of the medical care delivery system is envisioned to handle issues of quality and cost of services, but the committee concurs that “[h]ealth in all policies represents the most comprehensive level of health reform” and

OCR for page 73
81 INTERSECTORAL ACTION ON HEALTH “broadens the definition of health reform to include a consideration of the intentional or unintentional impact of all policies—health, social, economic and others—on individual or population health” (Georgia Health Policy Center, 2008, p. 17). HIAP and the Federal Government In the past several years, reports from U.S. blue ribbon panels have of- fered recommendations for a coordinated, intersectoral approach to govern- ing. For example, the Center for the Study of the Presidency and Congress issued a report by its Commission on U.S. Federal Leadership in Health and Medicine, which recommended the implementation of a HIAP approach across federal departments and agencies, including the creation of a federal coordinating council (Commission on the U.S. Federal Leadership in Health and Medicine, 2009). This approach was consonant with that expressed in a 2008 report from the Center for American Progress and the Institute on Medicine as a Profession, The U.S. Health Care System: A Blueprint for Reform, as follows: National and local policies, programs, and funding allocations that support health—not just health care—must be realigned and prioritized in order to meaningfully improve population health. This process can be informed by examining the factors underlying the health status measure “life expectancy from birth” which incorporates the main causes of premature death. These reside in five domains: behavioral patterns, social circumstances, environmental exposures, health care, and genetics. (Center for American Progress and The Institute on Medicine as a Profession, 2008, p. 98) Many of the themes of HIAP surfaced in the evolution of health care re- form legislation and took statutory form in some of the provisions included in the Affordable Care Act (ACA) by Congress in 2010. Specifically, the law called for the establishment of the National Prevention, Health Promotion, and Public Health Council. The Council, created by executive order of the President and convened by the Surgeon General of the US Public Health Ser- vice, constitutes the highest-profile HIAP action in the federal government. It brings together cabinet secretaries and heads of major agencies to develop a prevention strategy for the nation and to address national health priorities from an interdepartmental and interagency perspective. Despite the distinct statutory roles, responsibilities and priorities of the separate agencies, the Council calls on its executives to think creatively about ways in which their interests may be furthered by contributing to the nation’s prevention, health promotion, and public health strategy. Another example of HIAP in action is the Partnership for Sustainable Communities, a joint initiative by the Environmental Protection Agency (EPA), the Departments of Transportation (DOT), and Department of

OCR for page 73
82 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY Housing and Urban Development (HUD) that is intended to “stimulate a new generation of sustainable and livable communities that connect hous- ing, employment, and economic development with transportation and other infrastructure improvements” (EPA, 2011). The partnership has identified six livability principles, two of which explicitly refer to health.4 The initia- tive, which includes $100 million to fund regional plans in 45 regions of the country, exemplifies a holistic, or cross-cutting public policy approach that aims to “connect the dots” among the many factors that make com- munities livable and healthy: good schools, economic development, decent and affordable housing, accessible transportation infrastructures, and other features. The Healthy Food Financing Initiative is another example of intersec- toral action on health. The initiative “supports projects that increase access to healthy, affordable food in communities that currently lack these options, [t]hrough a range of programs at Departments of Agriculture, Treasury, and Health and Human Services (HHS)” (HHS, 2010). State food financing ini- tiatives, such as the Pennsylvania Fresh Food Financing Initiative begun in 2004, have led to the establishment of supermarkets in underserved areas. These not only make fresh and healthier foods available to communities, but they also serve as anchors for other types of economic activity, including other retail outlets (Cantor et al., 2009; PolicyLink, 2010; The Reinvest- ment Fund, 2008). HIAP in State and Local Governments Some state and local governments have already adopted HIAP ap- proaches. In February 2010, the governor of California issued Executive Order S-04-10, which authorized the California Strategic Growth Council (SGC) to establish a Health in All Policies Task Force as part of its larger mission to develop a sustainable economy for the state. This action explic- itly linked economic growth to the health of the people of California. The Task Force was charged with identifying “priority programs, policies, and strategies to improve the health of Californians while advancing the SGC’s goals.” To accomplish this, a multi-agency council was assembled to facili- tate collaboration in several areas, including air and water quality, protec- tion of natural resources, availability of affordable housing, promotion of public health, sustainable land use planning, and climate change goals 4 “Provide more transportation choices. Develop safe, reliable, and economical transporta- tion choices to decrease household transportation costs, reduce our nation’s dependence on foreign oil, improve air quality, reduce greenhouse gas emissions, and promote public health.” and “Value communities and neighborhoods. Enhance the unique characteristics of all commu- nities by investing in healthy, safe, and walkable neighborhoods—rural, urban, or suburban.”

OCR for page 73
83 INTERSECTORAL ACTION ON HEALTH (Health In All Policies Task Force, 2010b, p. 9). The SGC-convened Task Force includes 19 agencies, including the Office of the Attorney General, business, transportation, education, social services, and housing (Health In All Policies Task Force, 2010b). After a process that included soliciting and receiving public input and defining a vision of a healthy community, the task force developed a report with 34 recommendations. These were based on a set of criteria, including population health impact, overlap with SGC objectives, availability of supportive evidence, ability to foster collabora- tion, equity impact, measurability, feasibility, and ability to transform state government culture (Health In All Policies Task Force, 2010a). The report was adopted by the Strategic Growth Council. A HIAP approach has also been adopted in the master plan for Fort McPherson, an army base in Atlanta that is slated for closure (McPherson Planning Local Redevelopment Authority, 2006). A major objective of the redevelopment partnership’s effort is to meet a range of community needs, including those of vulnerable disadvantaged populations living in neighbor- hoods surrounding the installation. The partnership (involving the local redevelopment authority and public health experts) developed a list of guidelines that would be incorporated in the Master Plan for redevelopment and would call for specific features that benefit health (McPherson Planning Local Redevelopment Authority, 2006). The city of Atlanta agreed to incor- porate the partnership’s recommendations for zoning requirements. Mul- tiple efforts were made to involve surrounding communities in the planning discussions, which led to a plan based on principles of sustainable urbanism, including promoting public health. Access to a full-service supermarket, multi-income housing, recreation, green spaces, public transportation, and other amenities were among planners’ objectives (Avey, 2011). In an effort facilitated by the New York Academy of Medicine, and with the collaboration of the American Association of Retired Persons, the city of New York has implemented a variety of activities to become one of the World Health Organization’s (WHO’s) network of 35 age-friendly cities. The effort began with convening 22 city agencies, and has led to a range of commitments to make the city’s transportation, education, business, and other sectors and systems accessible to people of any age (Boufford, 2011). The WHO guidelines identify the following domains of urban life necessary for healthy aging: outdoor spaces and buildings, transportation, housing, social participation, respect and social inclusion, civic participation and employment, communication and information, and community support and health services (WHO, 2009). The field of community development finance is finding synergies with community health improvement efforts. Richter (2009) has observed that the vulnerable groups targeted by the Community Reinvestment Act are not only at risk financially, but also in terms of their health. These two

OCR for page 73
100 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY development of patient-centered outcome measures has become a priority for comparative effectiveness research and evaluation under health reform, to be implemented through the Patient-Centered Outcomes Research Insti- tute (PCORI), community-centered outcome measures, together with distal outcomes such as health-adjusted life expectancy, are needed to evaluate the full impact of laws on outcomes of importance to the public. Although the committee accepts the principle that all population health interventions, including laws, should be based on the best evidence available, it notes that the policy context determines the level of acceptable uncertainty in the data. In particular, the risk of harm (economic or health-related) that arises from implementing or failing to implement a law is highly relevant. More limited evidence may be used to craft legal interventions when health threats and potential harms from inaction are large; when opportunity costs and unintended harms from action are within acceptable limits; and when the time demands and/or other costs required for gathering more definitive evidence are large relative to the expected value of the additional evidence (a “value of information” analysis).10 Using weaker forms of evidence has the potential to increase the risk of false positives—the consequences of as- suming a public health law is effective when in fact it is not—but this risk needs to be balanced against the risk of false negatives—the consequences of inaction and delays in the implementation of potentially effective new laws. When weaker levels of evidence are used to justify new laws, stronger prospective evaluations are needed to assess impact and produce additional evidence over time. According to Kindig (2010), early childhood interven- tion is one area where inaction may have grave consequences. The evidence for various policy and other approaches is mixed and there are important remaining gaps in our knowledge, but the risk from not acting on what is known, or even partially supported by the evidence, can be great, as a generation of children grows up without some of the potentially essential ingredients for healthy development. A framework or matrix could be developed to illustrate the level of certainty and magnitude of effects that policymakers need depending on the type of policy decision.11 Variables that could be used to structure such a framework would include the level of risk presented by the legal interven- tion, the population impact of the health risk factors being targeted, and the type of legal action. Other factors include the potential scope of the policy, severity and frequency of the potential health effects, availability of other 10 I n some cases, it may be possible to undertake research during policy implementation (including so-called natural experiments that compare a jurisdiction that implements a specific policy to a similar jurisdiction that does not), or to implement in a manner that allows study of a policy’s effects. 11 A comprehensive discussion of evidentiary standards for population health interventions is available at: http://healthypeople.gov/2020/default.aspx.

OCR for page 73
101 INTERSECTORAL ACTION ON HEALTH options, prior experience using the intervention, and acceptability of poten- tial risks. Such a framework could help policymakers determine what type of evidence would be sufficient to enact a proposed policy: a recommendation from a credible source such as the Task Force on Community Preventive Services or the Cochrane Collaboration; a well-conducted evaluation of another jurisdiction’s experience with the policy; or simulation modeling that estimates the policy’s potential impact. In the case of a policy targeting a major risk factor for poor health, the combination of a well-constructed hypothesis and high risk to the population may call for applying the pre- cautionary principle and for taking action even in the absence of definitive evidence. Costs, along with health benefits and harms, are an increasingly impor- tant concern in evaluating the likely outcomes of proposed laws, policies, and regulations. Strategic planning requires the allocation of scarce resourc- es. It is often assumed that legal interventions have few costs. However, the cost analyses may not account for all relevant costs and externalities and may apply an individual or government perspective rather than tabulat- ing costs to society or to the agencies responsible for implementation and monitoring. Ultimately, the population health benefit and cost effectiveness of legal interventions might be compared directly with other investments, including medical care, designed to improve individual and/or population health. Finally, legal interventions deserve to be studied not only for their ef- fectiveness, but for their comparative effectiveness (both against other legal intervention and compared to other kinds of interventions). In an example of the former, Sturm et al. (2010) found that taxes applied to carbonated beverages that are reflected in the price on the shelf (i.e., excise tax) are more effective than taxes applied at the register (i.e., sales tax) in deterring consumer selection of such products. Moreover, the experience with tobacco taxes has taught public health officials about price elasticity—the extent to which smokers reduce demand for cigarettes as a result of cost increases (IOM, 2007). Research on the comparative effectiveness and health impact of public health laws and policies could be conducted by documenting geographic variation and temporal change in population exposure to specific policy and legal interventions. The system also can be used to track the progress of efforts to expand the geographic reach of effective policies and laws, and to identify unmet needs for policy development and advocacy strategies. A knowledge base exists for crafting an accepted framework for evaluating the evidence of public policies, but work by an interdisciplinary team of experts is needed to build on the existing literature, review methodological challenges, and arrive at a consensus on preferred criteria. An expert panel, given dedicated time and resources for the effort, could consider the vari- ous schemes that have been proposed for grading the evidence for outcomes

OCR for page 73
102 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY assessments of policies and regulations and derive new guidelines that the HIAP movement could embrace in setting evidence-based policy. Recommendation 10: The Committee recommends that HHS con- vene relevant experts to enhance practical methodologies for assess- ing the strength of evidence regarding the health effects of public policies as well as to provide guidance on evidentiary standards to inform a rational process for translating evidence into policy. Although functioning as convener, HHS would be one actor among many in this process. The guidance developed would include: (1) methods for as- sessing the certainty of effectiveness (benefits and harms), and, if effective, the magnitude of effect, for suitable populations; (2) methods for assessing the effectiveness of interventions (policies and programs) when used alone or in combination (i.e., their incremental and or synergistic benefits); and (3) priorities for and consideration of the contextual issues that should be taken into account when determining whether (and where) to implement policies. The contextual issues to be considered include importance of the problem (severity, frequency, burden of disease, cost), feasibility (afford- ability, acceptability), availability of alternatives, demand, fairness (equity), preferences and values, cost effectiveness, potential to advance other soci- etal objectives, potential for harms, legal and ethical considerations, and administrative options. The intention of this recommendation is to develop methodologies, but not to assess each individual policy. Not all policy that impacts health has governmental origins. Because the vast majority of U.S. economic activity is in the private sector, formal and informal policies ad- opted by business, foundations, and others have the potential to profoundly influence health. However, public health practitioners have limited knowl- edge of policy development and implementation in the nongovernmental sectors. Another important priority is to establish a clearinghouse of evidence to which policymakers (and developers of HIAs) can turn to study the out- comes of prior legal interventions. The practice of evidence-based medicine and public health is aided by the existence of powerful search tools that en- able users to query bibliographic databases and professional publications to identify, often within seconds, the best evidence for a clinical intervention. Building a similar capacity to evaluate the effects of agriculture, tax, hous- ing, economic, and education policies is a worthy priority: Unlike many other areas of public health research, research on public health law and policy has developed few surveillance systems. . . . Gathering information about the patterns of public health law adoption and implementation across states and local governments over time generally is done de novo in each re- search project. Maintaining and updating databases of laws would dramatically

OCR for page 73
103 INTERSECTORAL ACTION ON HEALTH improve researchers’ ability to conduct rigorous policymaking, mapping, inter- vention, implementation, and mechanism studies at low cost. High standards of transparency concerning the data-collection and coding protocols for such databases would allow subsequent researchers to update publicly available data sets at reasonable marginal cost. (Burris et al., 2010, pp. 194–195) A pilot project could be developed and implemented to assess the feasi- bility of monitoring and measuring this activity. To track laws and policies (largely public sector, but including, where practical, major policy areas in the private sector) that successfully influence the health of populations, a health policy surveillance system could be developed, pilot-tested, and sup- ported by CDC. Such a system would gather information on the geographic reach, scope, and timing of significant new laws and policies designed to promote health and prevent disease and disability at the population level. The surveillance system could include such health-related laws and policies adopted at federal, state, and local government levels, including laws that define regulatory and enforcement powers and duties for public health agencies and for other governmental entities. Although more dif- ficult to capture and assess, significant new health-related policies adopted by private organizations could also be included in the surveillance system, such as those adopted by employers, schools, health care institutions, and community-based organizations, to the extent such policies are made pub- lic and are brought to the attention of the surveillance system. A range of different methodologies for capturing information on private-sector health policies could be tested to determine an appropriate balance of validity, reli- ability, and feasibility. Some combination of active surveillance approaches and passive surveillance reporting through local public health agencies may be required. This second report of the committee has identified historical and ex- tant approaches to the use of law and policy in protecting and improving the health of the public. Law has been and will remain critical for creating the infrastructure that supports directed and accountable action, as well as for limiting some actions that diminish health, or requiring actions that enhance it. As the nation looks to true reform in its health system, and the ultimate goal of optimizing the health of the public, challenges, but also opportu- nities, exist in revisiting, refashioning, and applying laws to improve the health of Americans. The challenges are by no means minimal. The com- mittee is aware of the bureaucratic and administrative burdens and political turbulence that sometimes accompany the development or implementation of legislation, regulations, and policies. In addition, building the evidence base as it relates to forecasting potential benefits, harms, and costs, will be methodologically challenging, and will itself consume resources. Mandating efforts to do so is only appropriate when the methods, evidence and analytic

OCR for page 73
104 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY capacity are present. But building capacity to conduct this type of evidence- based evaluation and governance is key to understanding what works, to bring data and facts to a domain populated by opinions and politics, and to implement policies that are successful and efficient. The opportunity to substantially enhance public health—and with it the nation’s economy and workforce productivity—turns on the ability of gov- ernment and the private sector to shape public policies with closer and more mindful attention to health outcomes. Working together toward a goal of common interest—better health, a stronger economy, a vibrant society—also provides an opportunity for communities to build new models of collabora- tion and coordination that reduce inefficiency and maximize impact. This effort to bring partners and stakeholders together thereby becomes a vehicle not only for healthier communities but also a model for more productive discourse and policy formulation in other sectors. REFERENCES Abdollah, T. 2007. A strict order for fast food: The city council may consider a moratorium on allowing new outlets in south LA, where obestiy rates are high. Los Angeles Times. http://articles.latimes.com/2007/sep/10/local/me-fastfood10 (May 31, 2011). Adler, N. E., and J. Stewart. 2010. Health disparities across the lifespan: Meaning, methods, and mechanisms. Annals of New York Academy of Sciences 1186:5-23. Adler, N., J. Stewart, S. Cohen, M. Cullen, A. Diez Roux, W. Dow, G. Evans, I. Kawachi, M. Marmot, K. Matthews, B. McEwen, J. Schwartz, T. Seeman, and D. Williams. 2007. Reaching for a Healthier Life: Facts on Socioeconomic Status and Health in the U.S. Chicago, IL: The John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health. Alstona, J. M., D. A. Sumnera, and S. A. Vostia. 2008. Farm subsidies and obesity in the United States: National evidence and international comparisons. Food Policy 33(6):1-4. American Planning Association. 2002. Policy guide on smart growth: Motion to adopt a defini- tion of smart growth. Washington, DC: American Planning Association. Avey, H., and K. Minyard. 2011 (February 23). A Health In All Policies Approach to Large Scale Redevelopment: Fort McPherson BRAC (Base Realignment and Closure). Presenta- tion to the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities. Washington, DC: IOM. Aylott, J., I. Brown, R. Copeland, and D. Johnson. 2008. Tackling Obesities: The Foresight Report and Implications for Local Government. South Yorkshire, UK: Sheffield Hallam University. Barancik, J. I., C. F. Kramer, H. C. Thode, and D. Harris. 1988. Efficacy of the New York State seat-belt law—preliminary assessment of occurrence and severity. Bulletin of the New York Academy of Medicine 64(7):742-749. Bauman, A. E., and F. C. Bull. 2007. Environmental Correlates of Physical Activity and Walk- ing in Adults and Children. London, England: National Institute of Health and Clinical Excellence. Baxter, R. J. 2010. Making better use of the policies and funding we already have. Preventing Chronic Disease Public Health Research, Practice, and Policy 7(5):1-6. http://www.cdc. gov/pcd/issues/2010/sep/10_0055.htm (March 18, 2010).

OCR for page 73
105 INTERSECTORAL ACTION ON HEALTH Bell, J., and M. Standish. 2005. Communities and health policy: A pathway for change. Health Affairs 24(2):339-342. Bernstein, E., D. Pathak, L. Rutledge, and G. Demarest. 1989. New Mexico safety restraint law: Changing patterns of motor vehicle injury, severity, and cost. The American Journal of Emergency Medicine 7(3):271-277. Berwick, D. M. 2002. A user’s manual for the IOM’s “Quality Chasm” report. Health Affairs 21(3):80-90. Boufford, J. I. 2011 2011 AARP-UN Briefing Series on Global Aging. New York, NY: AARP and United Nations. Braveman, P., and S. Egerter. 2008. Overcoming Obstacles to Health: Report from the Robert Wood Johnson Foundation to the Commision to Build a Healthier America. Princeton, NJ: Robert Wood Johnson Foundation. Braveman, P. A., C. Cubbin, S. Egerter, D. R. Williams, and E. Pamuk. 2010. Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health 100:S186-S196. Braveman, P., S. Egerter, and D. R. Williams. 2011a. The social determinants of health: Coming of age. Annual Review of Public Health 32:381-398. Braveman, P. A., S. A. Egerter, S. H. Woolf, and J. S. Marks. 2011b. When do we know enough to recommend action on the social determinants of health? American Journal of Preven- tive Medicine 40(Suppl 1):S58-S66. Britten, R. H. 1938. Housing and health. American Journal of Public Health 28:957-960. Brownson, R. C., T. K. Boehmer, and D. A. Luke. 2005. Declining rates of physical activ- ity in the United States: What are the contributors? Annual Review of Public Health 26:421-443. Brownson, R. C., D. Haire-Joshu, and D. A. Luke. 2006. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health 27(1):341-370. Bryon, J. 2010 (September). Planning: Many Avenues Toward Health Improvement, Presen- tation to the Institute of Medicine Committee on Public Health Strategies to Improve Health. Washington, DC: IOM. Burris, S., T. Hancock, V. Lin, and A. Herzog. 2008. Emerging principles of healthy urban governance-thematic paper 5. Toronto, ON, Canada: Knowledge Network on Urban Settings and WHO Centre for Health Development. Burris, S., A. C. Wagenaar, J. Swanson, J. K. Ibrahim, J. Wood, and M. M. Mello. 2010. Mak- ing the case for laws that improve health: A framework for public health law research. The Milbank Quarterly 88(2):169-210. Butland, B., S. Jebb, P. Kopelman, K. McPherson, S. Thomas, J. Mardell, and V. Parry. 2008. Tackling Obesities: Future Choices. England: Government Office for Science. California Center for Public Health Advocacy, PolicyLink, and UCLA Center for Health Policy Research. 2008. Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes. Davis, CA: California Center for Public Health Advocacy, Policy- Link, and UCLA Center for Health Policy Research. Campbell, B. J., J. R. Stewart, and D. W. Reinfurt. 1991. Change in injuries associated with safety belt laws. Accident Analysis & Prevention 23(1):87-93. Cantor, J., L. Mikkelsen, D. Butler, and O. Sahak. 2009. Residents Live in Communities with Health-Promoting Land Use, Transportation, and Community Development. Los Ange- les, CA: The California Endowment. Capewell, S., and D. M. Lloyd-Jones. 2010. Optimal cardiovascular prevention strategies for the 21st century. Journal of the American Medical Association 304(18):2057-2058. CDC (Centers for Disease Control and Prevention). 2010. Overweight and Obesity: Economic Consequences. http://www.cdc.gov/obesity/causes/economics.html (June 29, 2010).

OCR for page 73
106 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY Center for American Progress, and The Institute on Medicine as a Profession. 2008. The Health Care Delivery System: A Blueprint for Reform. Washington DC: Center for American Progress. Cevero, R., K. Junhee, and S. Kevin. 2009. From elevated freeways to surface boulevards: Neighborhood and housing price impacts in San Francisco. Journal of Urbanism: Inter- national Research on Placemaking and Urban Sustainability 2(1):31-50. Chandra, A., and T. S. Vogl. 2010. Rising up with shoe leather? A comment on fair society, healthy lives (the Marmot review). Social Science & Medicine 71(7):1227-1230; discus- sion 1254-1228. Chen, S. E., and R. J. G. M. Florax. 2010. Zoning for health: The obesity epidemic and op- portunities for local policy intervention. The Journal of Nutrition 140(6):1181-1184. Chorbat, T. L., D. Reinfurt, and B. S. Hulka. 1988. Efficacy of mandatory seat-belt use legisla- tion: The North Carolina experience from 1983 through 1987. Journal of the American Medical Association 260(24):3593-3597. Clancy, C., L. Bilheimer, and D. Gagnon. 2006. Health policy roundtable: Producing and adapting research syntheses for use by health-system managers and public policymakers. Health Research and Education Trust 41(3):905-918. Commission on Social Determinants of Health. 2008. Closing the Gap in a Generation. Ge- neva, Switzerland: World Health Organization. Commision on the U.S. Federal Leadership in Health and Medicine. 2009. New Horizons for a Healthy America: Recommendations to the New Administration. Washington, DC: Center for the Study of the Presidency and Congress. Communities Count. 2008. Natural and built environments. In Communities Count 2008: Social and Health Indicators Across King County. Seattle, WA: Communities Count. Pp. 90-106. Cubbin, C., V. Pedregon, S. Egerter, and P. Braveman. 2008. Where We Live Matters for Our Health: Neighborhoods and Health. Princeton, NJ: Robert Wood Johnson Foundation. Dalla Valle, J. M. 1937. Some factors which affect the relationship between housing and health. Public Health Reports 52(30):989. Desai, A., and M.-B. You. 1992. Policy implications from an evaluation of seat belt use regula- tion. Evaluation Review 16(3):247-265. Diller, P. A., and S. Graff. 2011. Regulating food retail for obesity prevention: How far can cities go? Journal of Law, Medicine & Ethics 39:89-93. Emerson, J., T. Freundlich, and S. Berenbach. 2008. Triple-bottom line investing: Balancing financial, social and environmental returns. Community Investments–The Green Is- sue 20(2):17-20. http://www.frbsf.org/publications/community/investments/0808/sum- mer_2008.pdf (April 8, 2011). EPA (Environmental Protection Agency). 2011. HUD-DOT-EPA Interagency Partnership for Sustainable Communities. http://www.epa.gov/smartgrowth/partnership/index. html#background (September 8, 2010). Erickson, D., and J. S. Marks. 2011. The Federal Reserve wants to rebuild main street. In The Health Care Blog. http://thehealthcareblog.com/blog/2010/08/16/the-federal-reserve- wants-to-rebuild-main-street/ (April 7, 2011). Evans, G. W., and P. Kim. 2010. Multiple risk exposure as a potential explanatory mechanism for the socioeconomic status—health gradient. Annals of the New York Academy of Sci- ences 1186(1):174-189. Evans, W. D., and J. D. Graham. 1990. An estimate of the lifesaving benefit of child restraint use legislations. Journal of Health Economics 9:121-142. Fawcett, S., J. Schultz, J. Watson-Thompson, M. Fox, and R. Bremby. 2010. Building multi- sectoral partnerships for population health and health equity. Preventing Chronic Disease Public Health Research, Practice, and Policy 7(6):A118-A124.

OCR for page 73
107 INTERSECTORAL ACTION ON HEALTH Fawcett, S. B., V. T. Francisco, A. Paine-Andrews, and J. A. Schultz. 2000. A model memoran- dum of collaboration: A proposal. Public Health Reports 115(2-3):174-179. Finkelstein, E. A., C. J. Ruhm, and K. M. Kosa. 2005. Economic causes and consequences of obesity. Annual Review of Public Health 26(1):239-257. Federal Reserve Bank of San Francisco (FRBSF). 2010. Community Investments Online. http:// www.frbsf.org/publications/community/investments/1012/index.html (April 8, 2011). Garcia, R., and A. White. 2006. Healthy Parks, Schools, and Communities: Mapping Green Access and Equity for the Los Angeles Region: Policy Report. Los Angeles, CA The City Project. Georgia Health Policy Center. 2008. Finding the Voice of Public Health in the National Health Reform Dialogue: An Integrative Model for Health System Transformation. Atlanta, GA: Georgia State University. Goetzel, R. Z., D. R. Anderson, R. W. Whitmer, R. J. Ozminkowski, R. L. Dunn, J. Wasserman, and The Health Enhancement Research Organization Research Committee. 1998. The relationship between modifiable health risks and health care expenditures: An analysis of the multi-employer hero health risk and cost database. Journal of Occupational and Environmental Medicine 40(10):843-854. Gostin, L. O. 2010. Healthy people, healthy places: How to have a healthy life, commmunity, and country. Insights on Law and Society 11(1):12-30. Guerin, D., and D. P. MacKinnon. 1985. An assessment of the California child passenger restraint requirement. American Journal of Public Health 75(2):142-144. Harvie, A., and T. A. Wise. 2009. Sweetening the pot: Implicit subsidies to corn sweeteners and the U.S. obesity epidemic. Global Development and Environment Insititute. Policy Brief No. 09-01. Medford, MA: Tufts University. Health Impact Assessment Collaborative-San Francisco Bay Area. 2010. Case Studies. http:// www.hiacollaborative.org/case-studies (April 8, 2011). Health Impact Project. 2010. About Health Impact Assessment. http://www.healthimpactpro- ject.org/hia (February 17, 2010). Health In All Policies Task Force. 2010a. About Us. http://sgc.ca.gov/HIAP/about.html (April 8, 2011). Health In All Policies Task Force. 2010b. Health In All Policies Task Force: Final Report to the Strategic Growth Council. Sacramento, CA: Strategic Growth Council. HHS (Department of Health and Human Services). 2010. Healthy Food Financing Initiative. http://www.acf.hhs.gov/programs/ocs/ocs_food.html (May 31, 2011). Innvaer, S., G. Vist, M. Trommald, and A. Oxman. 2002. Health policy-makers’ perceptions of their use of evidence: A systematic review. Journal of Health Services Research Policy 7(4):239-244. IOM (Institute of Medicine). 2001. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press. IOM. 2003. The Future of The Public’s Health in the 21st Century. Washington, DC: The National Academies Press. IOM. 2004. Firearms and Violence: A Critical Review. Washington, DC: The National Acad- emies Press. IOM. 2007. Ending the Tobacco Problem: A Blueprint for the Nation. Washington, DC: The National Academies Press. IOM 2010. Transcript, Sixth Meeting of the Institute of Medicine Committee on Public Health Strategies to Improve Health. Washington, DC: IOM IOM. 2011. For the Public’s Health: The Role of Measurement in Action and Accountability. Washington, DC: National Academies Press. Jacobs, D. E., and A. Baeder. 2009. Housing Interventions and Health: A Review of the Evi- dence. Columbia, MD: National Center for Healthy Housing.

OCR for page 73
108 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY Jewell, C. J., and L. A. Bero. 2008. “Developing good taste in evidence”: Facilitators of and hinderances to evidence-informed health policy making in state government. The Milbank Quarterly 86(2):177-208. Juster, H. R., B. R. Loomis, T. M. Hinman, M. C. Farrelly, A. Hyland, U. E. Bauer, and G. S. Birkhead. 2007. Declines in hospital admissions for acute myocardial infarction in New York State after implementation of a comprehensive smoking ban. American Journal of Public Health 97(11):2035-2039. Kawachi, I., N. E. Adler, and W. H. Dow. 2010. Money, schooling, and health: Mechanisms and causal evidence. Annals of the New York Academy of Sciences 1186(1):56-68. Kegler, M. C., J. E. Painter, J. M. Twiss, R. Aronson, and B. L. Norton. 2009. Evaluation findings on community participation in the California Healthy Cities and Communities Program. Health Promotion International 24(4):300-310. Kelly, J. J. 2004. Refreshing the heart of the city: Vacant building receivership as a tool for neighborhood revitalization and community empowerment. Journal of Affordable Hous- ing 13(2):210-238. Kemm, J. 2006. Health impact assessment and health in all policies. In Health In All Policies: Prospects and Potentials, edited by T. Stahl, M. Wismar, E. Ollila, E. Lahtinen, and K. Leppo. Finland: Finnish Ministry of Social Affairs and Health and Health and European Observatory on Health Systems and Policies. Pp. 189-207. Kickbusch, I., and K. Buckett, eds. 2010. Implementing Health In All Policies: Adelaide 2010. Adelaide, South Australia: Department of Health, Government of South Australia. Kindig, D. A. 2010. Can we afford to wait for better evidence on improving child health? In Improving Population Health: Policy. Practice. Research: University of Wisconsin. Krieger, J., and D. L. Higgins. 2002. Housing and health: Time again for public health action. American Journal of Public Health 92(5):758-768. Levy, D. T., J. E. Bauer, and H.-R. Lee. 2006. Simulation modeling and tobacco control: Creat- ing more robust public health policies. American Journal of Public Health 96(3):494-498. Lovasi, G. S., M. A. Hutson, M. Guerra, and K. M. Neckerman. 2009. Built environments and obesity in disadvantaged populations. Epidemiologic Reviews 31(1):7-20. Mair, J. S., M. W. Pierce, and S. P. Teret. 2005. The Use of Zoning to Restrict Fast Food Out- lets: A Potential Strategy to Combat Obesity. Baltimore, MD, and Washington, DC: The Center for Law and the Public’s Health at Johns Hopkins and Georgetown Universities. Margolis, L. H., A. C. Wagenaar, and W. Liu. 1988. The effects of a mandatory child restraint law on injuries requiring hospitalization. American Journal of Diseases in Children 142:1099-1103. Marmot, M., and R. G. Wilkinson, eds. 1999. Social Determinants of Health. Oxford, UK: Oxford Press. Marmot, M. G., and R. G. Bell. 2011. Improving health: Social determinants and personal choice. American Journal of Preventive Medicine 40(1 Suppl):s73-s77. Marmot, M. G., S. Stansfeld, C. Patel, F. North, J. Head, I. White, E. Brunner, A. Feeney, and G. D. Smith. 1991. Health inequalities among British civil servants: The Whitehall ii study. The Lancet 337(8754):1387-1393. Marmot, M. G., H. Bosma, H. Hemingway, E. Brunner, and S. Stansfeld. 1997. Contribution of job control and other risk factors to social variations in coronary heart disease incidence. The Lancet 350(9073):235-239. Mays, G. P., P. K. Halverson, E. L. Baker, R. Stevens, and J. J. Vann. 2004. Availability and perceived effectiveness of public health activities in the nation’s most populous communi- ties. American Journal of Public Health 94(6):1019-1026. McCann, B., L. McRee, S. L. Handy, E. Meharg, L. Bailey, and R. Ewing. 2009. The Regional Response to Federal Funding for Bicycle and Pedestrian Projects. Davis, CA: Institute of Transportation Studies, University of California, Davis.

OCR for page 73
109 INTERSECTORAL ACTION ON HEALTH McMichael, A. J., M. Neira, R. Bertollini, D. Campbell-Lendrum, and S. Hales. 2009. Climate change: A time of need and opportunity for the health sector. Lancet 36(9):62031-62036. McPherson Planning Local Redevelopment Authority. 2006. McPherson Planning LRA. http:// www.mcphersonredevelopment.com/planning_lra.html. Miech, R. A., J. Kim, C. McConnell, and R. F. Hamman. 2009. A growing disparity in diabetes- related mortality: U.S. trends, 1989-2005. American Journal of Preventive Medicine 36(2):126-132. Muennig, P. 2008. Health selection vs. causation in the income gradient: What can we learn from graphical trends? Journal of Health Care for the Poor and Underserved 19:574-579. NPLAN (National Policy & Legal Analysis Network to Prevent Childhood Obesity). 2010. Establishing Land Use Protections for Community Gardens. Oakland, CA: NPLAN. Ollila, E., E. Lahtinen, T. Melkas, M. Wismar, T. Stahl, and K. Leppo. 2006. Towards a healthier future. In Health In All Policies: Prospects and Potentials, edited by T. Stahl, M. Wismar, E. Ollila, E. Lahtinen and K. Leppo. Finland: Finnish Ministry of Social Affairs and Health and European Observatory on Health Systems and Policies. Pp. 269-279. Piot, P., D. E. Bloom, and P. C. Smith. 2010. Towards a New Paradigm for Health for All. Geneva, Switzerland: World Economic Forum. PolicyLink. 2010. A Healthy Food Financing Initiative: An Innovative Approach to Improve Health and Spark Economic Development. Oakland, CA: PolicyLink. Pomeranz, J. 2011. The unique authority of state and local health departments to address obe- sity. American Journal Public Health:e1-e6, http://ajph.aphapublications.org/cgi/content/ abstract/AJPH.2010.300023v1 (May 12, 2011). Popkin, S. J., B. Theodos, L. Getsinger, and J. Parilla. 2010. An Overview of the Chicago Family Case Management Demonstration. Washington, DC: The Urban Institute. Preusser, D. F., A. F. Williams, and A. K. Lund. 1987. The effect of New York’s seat belt use law on teenage drivers. Accident Analysis & Prevention 19(2):73-80. Puska, P. 2008. The North Karelia project: 30 years successfully preventing chronic diseases. Diabetes Voice 53:26-29. Puska, P., and T. Ståhl. 2010. Health In All Policies—the Finnish initiative: Background, prin- ciples, and current issues. Annual Review of Public Health 31(1):315-328. Richter, L. 2009. Prescription for healthy communities: Community development finance. Com- munity Development Investment Review—Federal Reserve of San Fransisco 5(3):14-42. Rock, S. M. 1996. Impact of the Illinois Child Passenger Protection Act: A retrospective look. Accident Analysis & Prevention 28(4):487-492. Sargent, R. P., R. M. Shepard, and S. A. Glantz. 2004. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: Before and after study. British Medical Journal 328(7446):977-980. Schmier, J. K., M. L. Jones, and M. T. Halpern. 2006. Cost of obesity in the workplace. Scan- dinavian Journal of Work, Environment & Health 32(1):5-11. Schroeder, S. A., and D. L. Hughes. 2008. An agenda to improve the health of the public In The Health Care Delivery System: A Blueprint for Reform. Washington DC: Center for American Progress. Pp. 96-111. Seekins, T., S. B. Fawcett, S. H. Cohen, J. P. Elder, L. A. Jason, J. F. Schnelle, and R. A. Winett. 1988. Experimental evaluation of public policy: The case of state legislation for child passenger safety. Journal of Applied Behavior Analysis 21(3):233-243. Sewell, C. M., H. F. Hull, J. Fenner, H. Graff, and J. Pine. 1986. Child restraint law effects on motor vehicle accident fatalities and injuries: The New Mexico experience. Pediatrics 78(6):1079-1084. Sihto, M., E. Ollila, and M. Koivusalo. 2006. Principles and challenges of health in all poli- cies. In Health In All Policies: Prospects and Potentials, edited by T. Stahl, M. Wismar, E. Ollila, E. Lahtinen, and K. Leppo. Finland: Finnish Ministry of Social Affairs and Health and European Observatory on Health Systems and Policies. Pp. 3-20.

OCR for page 73
110 FOR THE PUBLIC’S HEALTH: REVITALIZING LAW AND POLICY Simon, P., C. J. Jarosz, T. Kuo, and J. E. Fielding. 2008. Menu Labeling as a Potential Strategy for Combating the Obesity Epidemic: A Health Impact Assessment (HIA). Los Angeles, CA: Los Angeles County Department of Public Health. Sorian, R., and T. Baugh. 2002. Power of information: Closing the gap between research and policy. Health Affairs 21(2):264-273. Streff, F. M., A. C. Wagenaar, and R. H. Schultz. 1990. Reductions in police-reported injuries associated with Michigan’s safety belt law. Journal of Safety Research 21(1):9-18. Sturm, R., L. M. Powell, J. F. Chriqui, and F. J. Chaloupka. 2010. Soda taxes, soft drink con- sumption, and children’s body mass index. Health Affairs 29(5):1052-1058. Syme, S. L., and M. L. Ritterman. 2009. The importance of community development for health and well-being. Community Development Investment Review 5(3):1-13. The Marmot Review. 2010. Fair Society, Health Lives: Strategic Review of Health Inequalities in England Post 2010. London, UK: The Marmot Review. The Reinvestment Fund. 2008. The economic impacts of supermarkets on their surrounding communities. Reinvestment Brief 4:1-18. The Urban Institute. 2010. An Overview of the Chicago Family Case Management Demonstra- tion. http://www.urban.org/publications/412254.html (April 8, 2011). Thyer, B. A., and M. Robertson. 1993. An initial evaluation of the Georgia safety belt use law. Environment and Behavior 25(3):506-513. TRB (Trasportation Research Board) and IOM (Institute of Medicine). 2005. Does the Built Environment Influence Physical Activity? Examining the Evidence—Special Report 282. Washington, DC: The National Academies Press. Twiss, J. M., J. Dickinson, S. Duma, T. Kleinman, H. Paulsen, and L. Rilveria. 2003. Commu- nity gardens: Lessons learned from California healthy cities and communities. American Journal of Public Health 93(9):1435-1438. Ulmer, R. G., C. W. Preusser, D. F. Preusser, and L. A. Cosgrove. 1995. Evaluation of Califor- nia’s safety belt law change from secondary to primary enforcement. Journal of Safety Research 26(4):213-220. Wagenaar, A. C., D. W. Webster, and R. G. Maybee. 1987a. Effects of child restraint laws on traffic fatalities in eleven states. The Journal of Trauma 27(7):726-732. Wagenaar, A. C., R. G. Maybee, and K. P. Sullivan. 1987b. Michigan’s Compulsory Restraint Use Policies: Effects on Injuries and Deaths. Ann Arbor, MI: University of Michigan Transportation Research Institute. Wallinga, D. 2010. Agricultural policy and childhood obesity: A food systems and public health commentary. Health Affairs 29(3):405-410. Wang, Y., M. A. Beydoun, L. Liang, B. Caballero, and S. K. Kumanyika. 2008. Will all Ameri- cans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity 16(10):2323-2330. WHO. 2009. WHO Global Network of Age-Friendly Cities, edited by WHO. Geneva, Switerland. Wier, M., C. Sciammas, E. Seto, R. Bhatia, and T. Rivard. 2009. Health, traffic, and environ- mental justice: Collaborative research and community action in San Francisco, California. American Journal of Public Health 99(Suppl 3):s499-s504. Williams, A. F., and J. K. Wells. 1981. Evaluation of the Rhode Island child restraint law. American Journal of Public Health 71(7):742-743. Wolf, A. M., and G. A. Colditz. 1998. Current estimates of the economic cost of obesity in the United States. Obesity Research 6(2):97-106. Woolf, S. H., R. E. Johnson, R. L. Phillips, Jr., and M. Philipsen. 2007. Giving everyone the health of the educated: An examination of whether social change would save more lives than medical advances. American Journal of Public Health 97(4):679-683. World Economic Forum. 2008. Working Towards Wellness: The Business Rationale. Geneva, Switzerland: World Economic Forum.