Building Sustainable Financing Structures for Population Health Insights from Non-Health Sectors: Proceedings of a Workshop (2018) / Chapter Skim
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Appendix C: Sustainable Financing Structures for Population Health: Historical Patterns and Insights for the Future: Commissioned Paper
Appendix C: Sustainable Financing Structures for Population Health: Historical Patterns and Insights for the Future: Commissioned Paper
Pages 71-90
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From page 71... ...
Nongovernmental organizations can offer support through investments where either marketrate or below-market returns are expected, grants where no returns are expected, or the in-kind provision of expertise or services.2 From an institutional perspective, policy can obviously be implemented by public institutions at the federal, state, and local levels. How 1 Research support for Anthony Orlando was provided by the Low Income Investment Fund and the Roundtable on Population Health Improvement.
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From page 72... ...
We then review four specific strategies that have been found to be effective and analyze the combination of institutions and rules to determine which levers have been important for achieving the observed success. Our goal is to provide a range of examples of successful policies for mitigating the adverse effects of social determinants of health and for the financing and institutional structures that produced them.
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From page 73... ...
But differences in four non-health categories -- environment, neighborhood, home, and economics -- also contribute to the widening differentials in public health that we observe between the more affluent and the poor, as well as between minorities and non-minorities. There is a vast and growing literature showing how these social determinants affect population health, yet far less attention has been paid to the design and financing of programs and policies that mitigate these factors.
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According to experts who studied and lived through the transformation, it was the Clean Air Act (CAA) , signed into law by President Richard Nixon on December 31, 1970.
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NEIGHBORHOOD In addition to the broader environment, the environment in a person's immediate neighborhood is also a social determinant of health. Concentrated poverty, crime, and food deserts, among other factors, have all been shown to be associated with poorer health outcomes.
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From page 76... ...
org/work/community-change/civic-sites/baltimore-civic-site (accessed July 25, 2018) ; The California Endowment, Investing in place, http://www.calendow.org/places (accessed July 7, 2017)
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From page 77... ...
Experts estimate that the cost of a universal housing voucher program would be an additional $20 to $40 billion; of course, a 9 Calculated using Table 1.1 -- Summary of receipts, outlays, and surpluses or deficits: 1789–2021, from the Office of Management and Budget, Historical Tables, https://www. whitehouse.gov/omb/budget/Historicals (accessed July 25, 2018)
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From page 78... ...
The public sector at both the federal and local level provides grants to improve housing quality, including grants for improved energy efficiency and climate control, and local communities are continually revising zoning and building codes to reflect new understandings gained about the costs and potential remedies of adverse housing quality.10 10 Improvements in warmth and energy efficiency tend to yield significant improvement in respiratory health, especially asthma. They also have the ancillary economic benefit of reducing fuel bills, improving social cohesion, and increasing work hours, all of which have indirect health benefits.
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1993. Understanding Title X: A practical guide to the Residential Lead-Based Paint Hazard Reduction Act of 1992, Alliance to End Childhood Lead Poisoning report, http://rst2.edu/ ties/lead/university/resources/leadsuite/Manuals/14FTITX.pdf (accessed July 25, 2018)
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. They have also spurred local governments, including those in Boston, Milwaukee, and Rochester, to fund their own lead hazard control initiatives.
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National Center for Healthy Housing, Policy: Federal Appropriations–FY 17, http:// www.nchh.org/Policy/National-Policy/Federal-Appropriations.aspx (accessed July 25, 2018)
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Programs designed to improve specific skills include job training programs run or sponsored by the U.S. Department of Labor, local public and private vocational school programs, community college specialized training courses, and apprenticeship programs run by unions, often in conjunction with employers (Holzer, 2014)
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. Most concerning, however, is the recent discovery that students who attended highachieving "No Excuses" charter schools in Texas did not experience any significant increase in earnings after they graduated -- and charter school students as a whole actually experienced a decrease in earnings relative to their peers who attended public schools (Dobbie and Fryer, 2016)
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The more "co-benefits" we can find, adopting programs that tackle multiple social determinants of health at once, the more cost-effectively we can achieve our goal of a healthy population. CONCLUSION In the context of a framework for categorizing social determinants of health, this paper has tried to provide examples of successful policy interventions with some focus on the financing and institutional arrangements that facilitated their effectiveness.
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From page 85... ...
Creativity in program design and implementation is therefore critical in understanding the essential elements for program success and how they work in different local circumstances. This consideration motivated the Small Area Fair Market Rents demonstration, an experiment by HUD that represents a first step toward introducing MTO-type mobility to the entire housing choice voucher program (Kahn and Newton, 2013)
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. The paper was prepared for the workshop titled Building Sustainable Financing Structures for Population Health, which was held in Washington, DC, on October 19, 2016.
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From page 87... ...
Economic Policy Institute. http://www.epi.org/publication/ poor-people-work-a-majority-of-poor-people-who-can-work-do (accessed July 25, 2018)
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2014. Healthy homes and lead hazard control, edited by the National Center for Healthy Housing.
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From page 89... ...
U.S. Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control.
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