Addressing Population Health and Health Inequalities: The Role of Fundamental Causes

Details

• Alternative Title:
  Am J Public Health
• Personal Author:
  Cerdá, Magdalena ; Tracy, Melissa ; Ahern, Jennifer ; Galea, Sandro
• Description:
  Objectives
  
  As a case study of the impact of universal versus targeted interventions on population health and health inequalities, we used simulations to examine (1) whether universal or targeted manipulations of collective efficacy better reduced population-level rates and racial/ethnic inequalities in violent victimization; and (2) whether experiments reduced disparities without addressing fundamental causes.
  
  Methods
  
  We applied agent-based simulation techniques to the specific example of an intervention on neighborhood collective efficacy to reduce population-level rates and racial/ethnic inequalities in violent victimization. The agent population consisted of 4000 individuals aged 18 years and older with sociodemographic characteristics assigned to match distributions of the adult population in New York City according to the 2000 US Census.
  
  Results
  
  Universal experiments reduced rates of victimization more than targeted experiments. However, neither experiment reduced inequalities. To reduce inequalities, it was necessary to eliminate racial/ethnic residential segregation.
  
  Conclusions
  
  These simulations support the use of universal intervention but suggest that it is not possible to address inequalities in health without first addressing fundamental causes.
  
  
• Subjects:
  Aging Computer Simulation Crime Victims Ethnicity Health Status Disparities Humans Models, Theoretical Racial Groups Residence Characteristics Socioeconomic Factors Stress Disorders, Post-Traumatic

  More +
• Source:
  Am J Public Health. 104(0 4):S609-S619.
• Pubmed ID:
  25100428
• Pubmed Central ID:
  PMC4126171
• Document Type:
  Journal Article
• Funding:
  1K01DA030449/DA/NIDA NIH HHS/United States ; DP2 HD080350/HD/NICHD NIH HHS/United States ; DP2HD080350/DP/NCCDPHP CDC HHS/United States ; K01 DA030449/DA/NIDA NIH HHS/United States ; R21 AA021909/AA/NIAAA NIH HHS/United States ; R21AA021909/AA/NIAAA NIH HHS/United States
• Volume:
  104
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1667726052b1ae51210049767f6ca8f3e8eed601e09fbb885cd9bd4716922905
• Download URL:
  https://stacks.cdc.gov/view/cdc/30072/cdc_30072_DS1.pdf
• File Type:
  [PDF - 2.06 MB ]