Discover and read the best of Twitter Threads about #SDOH

Most recents (24)

New @NASEM_Health @theNAMedicine report “Integrating Social Care Into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health” #SocialCare

full report: nationalacademies.org/SocialCare

Summary in @JAMA_current

My THREAD 1/18

ja.ma/2opPlEz
Great committee of outstanding experts in medicine, public health, social work, healthcare financing, digital platforms, implementation sciences, nursing, law, gerontology, health equity #SocialCare cc: @djmasonrn @KedarMate @LisaCooperMD @KBDeSalvo (2/18)
Why this topic?

⬆️ healthcare spending, but outcomes lag

⬆️ focus on healthcare value

Social factors ▶️ health, but not necessarily addressed in healthcare

⬆️ activity integrating social care into healthcare -> need framework to design/evaluate/improve #SocialCare (3/18)
Read 19 tweets
#TRIBECON begins #Pravara; felicitations to #AbhayBang @SearchGad & #sudarshan #VGKK for their inspiring work on #TribalHealth; @DrLahariya @whoindia among others felicitated
#abhayBang #healthsystem design for tribal communities need to be relooked for #UHC; strategies & schemes must adapt with local social & cultural context; recollects #Brainstorming with @DesirajuKeshav at @SearchGad leading to #ExpertCommittee #tribalhealth @TribalHealthIND
#TRIBECON #AbhayBang notes with happiness increasing interest in #tribalhealth research, yet this continues to be “off the beaten path”; congratulations to #pravara medical college in bringing this together; the proposed #Bandardhara declaration to improve #tribalhealth research
Read 81 tweets
#MedTwitter has been discussing “Take Two Aspirin + Call Me By My Pronouns,” an op-ed claiming social justice is taking time from sci ed + decreasing the quality of #MedEd.

So here’s my take:
“Take Two Aspirin + Read a Curriculum”
THREAD.

#MedTwitter #SoMeDocs #DoubleDocs
As always, I start threads with my POV: #LatinasInMedicine #DoubleDocs student in year 2 of #medschool. I have interests in both #MedEd + #HealthJustice. I am about to finish my term as diversity rep on our med student govt. I care a lot about advocacy.
Let’s take a moment to learn about the author: Stanley Goldfarb is a nephrologist, *former* assoc dean of curriculum at UPenn Med. He graduated from med school in 1969. Ffolks who studied at UPenn have brought up negative experiences with Dr. Goldfarb.
Read 55 tweets
Thanks, Mr Hennessey. Apropos for the @WSJopinion deputy editor to label the respondents to the outrageous and iconoclastic op-ed as "intersectional lunatics."
On the money? No. Audacious? Yes.
#SDoH #medtwitter
@WSJopinion The only problem, Mr Hennessey, is that you proved a point, but it wasn't that one.
@WSJopinion Here's @P_Yerramilli's response @statnews with the right points statnews.com/2019/09/16/med…
Read 4 tweets
As voted upon, a #Tweeotorial #Medthread:
#perioperative medicine meets #backtobedside
.
.
.
so let’s talk about functional capacity and METS!

1/x
METS?
“metabolic equivalent of task”

Huh?

Have you ever seen that report out on exercise equipment? Usually a number < 10?
It’s a measure of physical activity via oxygen consumption

Again, huh? #backtobedside??
Stay with me…
2/x
en.wikipedia.org/wiki/Metabolic…
Recall that the 2007 and 2014 ACC/AHA perioperative guidelines both include a step in their algorithms that no additional ischemic testing is recommended for patients who can achieve > 4 METS

So...how about those METS???
3/x
Read 27 tweets
New in @socscimed: We study the impact of IMF structural adjustment programs on health in developing countries; w/ T Forster, @thomstubbs, L King

In short: IMF programs increase neonatal mortality & lower access to health systems.

THREAD.

Open-access: doi.org/10.1016/j.socs…
International organizations are broadcasting their commitment to aiding #SDG attainment. But might their actual policy advice hurt progress towards these goals? We look at the case of the #IMF.

2/9
IMF structural adjustment programs—mandating austerity, deregulation, liberalization, & privatization—have been the workhorse of neoliberal globalization. For the history of such policies, see here:

3/9

Read 10 tweets
@EricTopol @NewYorker @joshuarothman @MelvinBackman Yes! But a few thoughts:

1) We should organize as health workers, not doctors.

2) We need to avoid saviorism, learn allyship.

3) We need to organize for self-protection, quality patient care, better societal structures, and the political change that enables all of the above.
@EricTopol @NewYorker @joshuarothman @MelvinBackman 4) We need to learn from actual organizers e.g.:

@resist_school from the community organizers who trained Obama youtube.com/channel/UCqC33…

@momentum_tweets of Sunrise/GND prominence youtube.com/user/MovementM…

@rsgexp No Shortcuts, and listen to this:
@EricTopol @NewYorker @joshuarothman @MelvinBackman @resist_school @momentum_tweets @rsgexp 5a) We need to fix the meta-narrative from the technical, utilitarian "health units aren't optimized or equitable one."

We must focus more on the personal, inter-personal, and moral.
Read 21 tweets
My next session on methods for complex data is happening now in Nicollet A!

I’ll be talking about pragmatic trials & per-protocol effects.
But first, @JessiePBuckley for Alex Keil on a new g-computation approach for causal effects of exposure mixtures.

One benefit over existing approaches: unlike weighted quartile sums regression, this method doesn’t assume all components work in the same direction.
There’s a preprint, so I’ll for sure be checking that out! The link is: arxiv.org/abs/1902.04200
Read 10 tweets
My approach to family meetings in the ICU & some #TipsForNewDocs I've learned along the way. Here is my approach - - my favorite part is the mandatory interpreter!
<THREAD>
Set the stage: invite the right people (HCP, RN), consider ambiance & setup, have a plan w objectives but manage your own expectations! It's work to you, but life & death to the family.

Sometimes the patient's room itself is the best location, esp if they can participate!
✨The Jargonese Interpreter ✨
Empower someone to interrupt you & ask for clarifications before the meeting. "Can you explain what you mean by ventilation?"

We use way more jargon than we think, and the family may not ask for nearly as much translation as is needed.
Read 16 tweets
1/ #medtwitter #twitternists #proudtobeGIM

I've been sitting on a @SocietyGIM #sgim19 debrief #medthread since the meeting, and thought I might finally take a swing at it - here goes ..

I am considering whether I can do more division/systems leadership in coming years .. ->
2/ Theme of the conference was 'Courage to Lead', and single best workshop for me was :

Leading Change: Tools/Tips for Change Management

Crediting Alfred Burger, Emily Fondahn, Brent Petty, Nathan Spell, Dan Steinberg - can't find them on Twitter, so giving proper 🗣🗣.
3/ would like to share key concepts for all of us trying to lead in academic medicine or in #advocacy spaces.

First key Slide/thoughts:

The hard stuff - barriers to change .. ->
Read 16 tweets
I want to put a 🙌 out to #MedTwitter

I may not tweet a lot but I do follow and gain quite a bit so I want to share how it has changed the way I carry myself and provide care.

It’s a thread.
2/
Patient asks the case manager when the doctor is going to see him

I spent 30 minutes updating him earlier that day 🤔

Pre-twitter: ok
Post-twitter: Sir, I’m in charge of your care, tell me a bit more about why you didn’t think I was your doctor.
#WomenInMedicine @AMarshallMD
3/
Overhear the nurses talking about a patient who made a veiled but serious threat to them during the course of care.

Pre-twitter: I’m sorry.
Post-twitter: 😠 that’s not OK. How can I support you?

#MedTwitter #NurseTwitter
@BrowofJustice
Read 11 tweets
Today’s @ONS data shows a staggering level of variation in the years of life you can expect to live in good health in England and Wales depending on your social and economic circumstances. (1/3)
People born in the most deprived areas of England are expected to have over 18 fewer years of life in good health than those born in the least deprived areas. (2/3)
To reduce these stark inequalities, cross-government action and investment is needed on the wider determinants that influence our health.

Watch our animation below to find out more and read our full response to the @ONS release here: health.org.uk/news-and-comme… (3/3)

#SDoH
Read 3 tweets
Disconnection from nature can be bad for our mental health.

qz.com/1557308/psycho…
“What I am attempting to do now is develop a rich psychoterratic typology that provides a language and conceptual landscape to match the rich range of emotions and feelings people have about nature and place."

psychoterratica.com/more.html @GlennAlb
To see that societies & natural environments continually ‘co-produce’ each other in the same spot is to understand our problem synthetically as one of ‘humanity-in-nature’ and ‘nature-in-humanity’ rather than merely additively as one of humanity & nature.

Read 12 tweets
Handing public assets and services over to the free market has been a boon for corporate America and a disaster for the working class.

#SDoH #HiAP #Interdependence inthesetimes.com/article/21689/…
“We can decide what makes public ownership efficient. We can decide what makes public ownership successful and that doesn’t have to be a profit, unlike private corporations. That could be environmental sustainability and is in many cases.”

thenextsystem.org/learn/stories/…
The latent, unused power of citizens—and the production of public collateral.

“To grasp and deploy this financial power in the interests of society and the ecosystem, citizens need to understand that this was and is ultimately our power.”

thenextsystem.org/learn/stories/…
Read 6 tweets
I will do my best to state this concisely, but of course difficult in a tweet.
1 - In order for there to be trust, there must be full recognition and accounting of the harm that has been created to FB patient support groups, so that people like @itsMandaPanda have justice for what happened to them. That must be initiated by Facebook.
Read 12 tweets
In case @hmkyale + @drjrums wonder why I got so shirty about JAMA article calling for #SDOH mining from social networks like, say, Facebook (shirty evidence here: threadreaderapp.com/thread/1075892…) allow me to expound. #cyberwoke
First, ICYMI, Facebook's treachery against patient + #MeToo communities in wake of Cambridge Analytica cock-up reveal. PHI revealed in what members thought were walled gardens? NOPE. cnbc.com/2018/07/11/fac… #HBOC #cyberwoke
Then there was the #MeToo community - 10s of 1000s of members - that got its plug pulled when they complained: wired.com/story/how-a-me… #cyberwoke
Read 10 tweets
OK. So there's a piece (no paywall) on @JAMA_current today by Freddy Abnousi (head of #healthcare @facebook), @hmkyale, +@DrJRums "Social Determinants of Health in the Digital Age: Determining the Source Code for Nurture." jamanetwork.com/journals/jama/… #cyberwoke /1
Before you think this is any kind of good news, remember that @Facebook has successfully incinerated democracy in several places, in the process turning all of us into meat puppet data cash machines (we don't get the cash) and now ... #cyberwoke /2
In addition to knowing where we are, who we're with, what we like, and what we think, they want our health data? How big of a FUCK NO, NO WAY, OMFG HAVE YOU LOST YOUR EVERLOVIN' MIND will we have to raise to kill this? #cyberwoke /3
Read 9 tweets
“Community wealth building models include social enterprises, community development corporations, employee stock ownership plans (ESOPs), municipally owned enterprises, community land trusts, and cooperatives.”

#SDoH #HiAP #PEoH #IRoS
“That has major implications for national productivity and economic growth, not to mention politics. A country in which a handful of coastal cities represent the bulk of national wealth is not a stable one.”

#SDoH #HiAP #Interdependence ft.com/content/8f33fe…
“The number of land banks grew dramatically in the wake of the foreclosure crisis. So has our understanding of how to successfully fund them.”

#SDoH #HiAP #Interdependence shelterforce.org/2018/11/13/how…
Read 6 tweets
“Job growth is not sufficient by itself to create upward mobility... It’s almost as though racial disparities have been amplified by job growth.”

#SDoH #HiAP #Interdependence apnews.com/20c455e8126b41…
“...while nonparticipation of prime-age males has risen in every education group, the biggest rise is not in the lowest-skill or highest-skill groups, but rather in the middle.”

#SDoH #HiAP #Interdependence conversableeconomist.blogspot.com/2018/10/why-is…
“Well-being metrics can serve as warning lights; they point to vulnerabilities in particular places or groups of people and to positive trends that could provide broader lessons.” #SDoH #HiAP #IRoS science.sciencemag.org/content/362/64…
Read 198 tweets
I've been researching the idea of Unconditional Basic Income since 2013. Here's a list of findings I've compiled from various UBI experiments, unconditional cash transfer studies, and cash dividend research.

The data speaks for itself.

Data: reddit.com/r/BasicIncome/… #basicincome
1) "The design and framing of Mincome led participants to view payments through a pragmatic lens, rather than the moralistic lens through which welfare is viewed… this paper finds that Mincome participation did not produce social stigma."

onlinelibrary.wiley.com/doi/10.1111/ca… #BasicIncome
Although there was a slight decrease in hours worked per year when primary earners were provided a basic income guarantee in the 1970s, that emerged as a result of spending more time between jobs, reasonably looking for a *good* job instead of *any* job.

academia.edu/1159217/A_fail…
Read 21 tweets
A Balanced Investment Portfolio For Equitable Health And Well-Being Is An Imperative, And Within Reach

#SDoH #HiAP #Interdependence
Social Determinants As Public Goods.

@LenMNichols & @LaurenTaylorMPH demonstrate that the underprovision of interventions on #SDoH can be addressed through a novel but practical community financing mechanism.

#Commons #Interdependence healthaffairs.org/doi/10.1377/hl…
“While the degree to which human beings pursue that which they think is good for them has not and will probably never change, what they believe is good for them can change and from time to time has, radically.”

#SDoH #HiAP #PEoH #IRoS
Read 7 tweets
Given the #NHS70 'birthday present', thought I'd share my reflections on recent changes to funding for health, public health, & social care in England. This is based on a talk I just gave to @DartmouthInst in US.
Credit @TheIFS, @HealthFdn, @TheKingsFund & others for images. 1/
Both in the US and England, the balance of money and political power lies firmly with the (acute) provider sector at the expense of community orgs, public health, social services, and (perhaps to a slightly lesser extent) mental health and primary care. 2/
Yet, very little of what determines both individual and population health is due to the provider sector, instead, social determinants and unhealthy behaviours are much more important. #SDOH 3/
Read 18 tweets
Housing And Health: An Overview Of The Literature

@LaurenTaylorMPH 2018 @Health_Affairs #SDoH

Housing stability, quality, safety, and affordability all affect health outcomes, as do physical and social characteristics of neighborhoods. healthaffairs.org/do/10.1377/hpb…
Exploring the link between housing and health

#SDoH #HiAP #PEoH #IRoS @amyreports @Marketplace marketplace.org/2018/06/13/hea…
The @HousingACTION campaign has released a new fact sheet highlighting the role of the Low-Income Housing Tax Credit in improving health outcomes for low-income families and communities. #SDoH #HiAP #PEoH static1.squarespace.com/static/566ee65…
Read 101 tweets
The effects of public health policies on health inequalities: a review of reviews. Thomson et al, 2017.

“...fiscal and regulation policies were more beneficial for reducing or preventing health inequalities than educational campaigns.”

#SDoH #PEoH #HiAP thelancet.com/pdfs/journals/…
“...how broad policy initiatives for tackling inequalities in health that start off with social determinants (upstream) approach drift downstream to largely individual lifestyle factors, as well as the general trend of investing a the individual level.”
“The consequence of this is a widespread public sector culture in which well-meaning policymakers, practitioners, researchers and members of the public collude in sustaining a ‘cargo cult’ of health behaviorism.” #SDoH #HiAP #PEoH
Read 28 tweets

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