Determining the Optimal Outcome Measures for Studying the Social Determinants of Health

Int J Environ Res Public Health. 2020 Apr 27;17(9):3028. doi: 10.3390/ijerph17093028.


Americans have significantly poorer health outcomes and shorter longevity than citizens of other industrialized nations. Poverty is a major driver of these poor health outcomes in the United States. Innovative anti-poverty policies may help reduce economic malaise thereby increasing the health and longevity of the most vulnerable Americans. However, there is no consensus framework for studying the health impacts of anti-poverty social policies. In this paper, we describe a case study in which leading global experts systematically: (1) developed a conceptual model that outlines the potential pathways through which a social policy influences health, (2) fits outcome measures to this conceptual model, and (3) estimates an optimal time frame for collection of the selected outcome measures. This systematic process, called the Delphi method, has the potential to produce estimates more quickly and with less bias than might be achieved through expert panel discussions alone. Our case study is a multi-component randomized-controlled trial (RCT) of a workforce policy called MyGoals for Healthy Aging.

Keywords: anti-poverty policies and health; outcome measures; randomized-controlled trial; social determinants of health; social policies and health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Developed Countries
  • Humans
  • Income*
  • Outcome Assessment, Health Care*
  • Public Policy
  • Randomized Controlled Trials as Topic
  • Social Determinants of Health*
  • United States