The era of Public Health 3.0 is an exciting time of innovation and transformation. With the Public Health 3.0 framework, we envision a strong local public health infrastructure in all communities and its leaders serving as Chief Health Strategists that partner with stakeholders across a multitude of sectors on the ground to address the social determinants of health. With equity and social determinants of health as guiding principles, every person and every organization can take shared accountability to ensure the conditions in which everyone can be healthy regardless of race, ethnicity, gender identity, sexual orientation, geography, or income level. If successful, such transformation can form the foundation from which we build an equitable health-promoting system -- in which stable, safe, and thriving community is a norm rather than an aberration. The Public Health 3.0 initiative seeks to inspire transformative success stories such as those already witnessed in many pioneering communities across the country.
The primary nonmedical factor affecting health is socioeconomic status. Socioeconomic status may be assessed by wealth (either individual wealth or family income), education (higher education is associated with better economic outcomes), or occupation (which provides financial benefits as well as benefits from expanded social networks) (11), although Americans primarily associate income or wealth with socioeconomic status. Income inequality in the United States continues to grow: The top 1% of earners make 3 times what they did in the 1980s, whereas the bottom 50% earn the same average income they did in 1980 (12). Not only is the income gap widening, the percentage of persons earning more than their parents has been decreasing. Members of the millennial generation, generally classified as persons born between 1981 and 1997, have only a 50% chance of earning more than their parents (12).
Socioeconomic factors can have a major impact on a person's health, however, new research finds that individuals with acute or chronic conditions think of these factors differently than the more mainstream narratives found in academic papers and the media. To better understand existing gaps and explore opportunities to improve support, the Anthem Public Policy Institute partnered with Quid, a research platform that can analyze large volumes of text-based data, to examine thousands of academic papers, news articles, and public posts on online patient forums. This is the first research project to capture patient perspectives on social determinants at this scale and scope. "While there has been a lot in the media and academic research on social determinants of health, no one has ever compared the focus of that work with the perspectives of individuals who have chronic or acute conditions to determine whether their priorities are aligned," said Jennifer Kowalski, vice president of the Anthem Public Policy Institute. "By better understanding how individuals view and talk about social determinants, payers and providers alike can identify new and improved ways to engage with them to more effectively improve their health and wellbeing and the delivery of healthcare."
The Hippocratic oath states: "first do no harm." In today's era of personalized medicine, we are trying to uphold this oath, but we also break it. Modern medicine has moved away from this oath in many ways. But new technologies that enable personalized medicine and a population-based approach to health will be the key to making Hippocrates' vision come true. Physicians today focus on specific diagnoses and specialized treatments, both of which were espoused by the Knidian school.
The BU School of Public Health has signed a five-year partnership with digital health company Sharecare to mine health and community data to improve well-being nationwide. SPH and Sharecare will build a Community Well-Being (CWI) Index using a vast trove of health data collected by Sharecare combined with SPH data on social determinants of health, all mined by the SPH Biostatistics and Epidemiology Data Analytics Center (BEDAC). The Index will highlight the critical impact that environment has on one's overall health. "The innovation is in taking the individual and placing them in their context," says Sandro Galea, dean of the School of Public Health and Robert A. Knox Professor. "This is a partnership between us and Sharecare to help advance what they've done before to the next level."