Discover and read the best of Twitter Threads about #SDOH
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🧵 Hello from day 1 of the Communicable Diseases & Immunisation Conference 2023. The Opening Plenary, starting now, is titled 'Whole of society: future approach to infectious diseases prevention and control'. #CDIC2023 
@BizEventsPerth @terryslevin @tarunw @HelenSMarshall @abcperth @healthgovau @_PHAA_WA Sandra Harben is now giving the Welcome to Country. We're on Whadjuk Noongar land today. #CDIC2023
@BizEventsPerth @terryslevin @tarunw @HelenSMarshall @abcperth @healthgovau @_PHAA_WA Prof @HelenSMarshall AM chairs the Opening Plenary today. #CDIC2023
The debate on whether we should add folic acid to food has been going on since I was a medical student.
In last week’s @bmj_latest, @munkeatlooi looks at some of the pros, cons and evidence.
Social inequalities play into this too.
Link:
bmj.com/content/381/bm…
#SDOH
In last week’s @bmj_latest, @munkeatlooi looks at some of the pros, cons and evidence.
Social inequalities play into this too.
Link:
bmj.com/content/381/bm…
#SDOH
Folic acid has been a hot topic for years.
We know that supplementation of this vitamin during pregnancy reduces the chances of having a baby with a neural tube defect (NTD) eg spina bifida, which can cause significant disabilities.
But not everyone takes it.
We know that supplementation of this vitamin during pregnancy reduces the chances of having a baby with a neural tube defect (NTD) eg spina bifida, which can cause significant disabilities.
But not everyone takes it.
Quote:
“Women can get folic acid from their diet, but current diets are unlikely to meet recommended levels. This is because of low intakes of whole foods that contain folic acid, particularly among more disadvantaged groups that face systemic barriers to eating well…”
“Women can get folic acid from their diet, but current diets are unlikely to meet recommended levels. This is because of low intakes of whole foods that contain folic acid, particularly among more disadvantaged groups that face systemic barriers to eating well…”
At #SHMConverge23 Dr. Aziz Ansari from @LoyolaMedMD and I presented this talk.
We were expecting *maybe* 100 attendees.
Instead, we had SRO (350+) in the room, and others turned away at the door.
Why??? A reflective 🧵 (1/11)
We were expecting *maybe* 100 attendees.
Instead, we had SRO (350+) in the room, and others turned away at the door.
Why??? A reflective 🧵 (1/11)
2/ In conversation with our audience, LOS (or, if you prefer, “LOS O:E”) is going up everywhere. Exasperation was palpable.
More to the point: people are TIRED…tired of their performance being judged by this antiquated metric.
And, tired of being asked to “fix” it.
More to the point: people are TIRED…tired of their performance being judged by this antiquated metric.
And, tired of being asked to “fix” it.
3/ This is the Iceberg Model of Systems Thinking.
LOS is an “event.” Therefore, measuring hospitalist performance based on LOS is superficial.
Any hospitalist will tell you it’s the “stuff” beneath the surface that drives LOS
LOS is an “event.” Therefore, measuring hospitalist performance based on LOS is superficial.
Any hospitalist will tell you it’s the “stuff” beneath the surface that drives LOS
1/6 Interesting work from Dr. William Encinosa and colleagues, with #Black #children disproportionately affected...
#complications #adverse #drug #events #costs #disparities #multisystem #inflammatory
#syndrome #MISC #children #COVID19 #LongCovidKids
jamanetwork.com/journals/jaman…
#complications #adverse #drug #events #costs #disparities #multisystem #inflammatory
#syndrome #MISC #children #COVID19 #LongCovidKids
jamanetwork.com/journals/jaman…
2/6 "Did outcomes vary by the number of organ systems affected in #multisystem #inflammatory #syndrome in #children (MIS-C) in 2021?"
3/6 "In this cross-sectional study of 4107 #MISC #hospitalizations, as the number of #organ #systems affected increased from 2 to 6 or more, mortality increased from 1% to 6%, length of stay doubled from 4 to 8 days,..."
1/4 "... several #sociodemographic and #socioeconomic factors as predictors of #LongCovid including lower #household #income levels, being #Hispanic, #female, #gay/#lesbian or #bisexual, and #divorced or #separated.
2/4 "Even after accounting for such factors, having #LongCovid was linked to higher risks of recent #unemployment, #financial #hardship, and #anxiety and #depressive #symptomatology, with evidence of dose-response relationships."
3/4 "Overall, an estimated 27.3 million US adults with #LongCovid were at risk of adverse #socioeconomic and #health outcomes including #anxiety and #depression."
#SDOH #social #determinants of #health
#SDOH #social #determinants of #health
The @CroakeyNews bulletin is emailed to subscribers every Thursday.
Here's a wrap of this week's stories...
"Consumer submissions to the Parliamentary inquiry provide a detailed picture of diverse experiences of people with #LongCOVID" @JenniferDoggett
croakey.org/listen-to-the-…
Here's a wrap of this week's stories...
"Consumer submissions to the Parliamentary inquiry provide a detailed picture of diverse experiences of people with #LongCOVID" @JenniferDoggett
croakey.org/listen-to-the-…
"Looking at that quote & the Grattan Report side by side, it’s easy to feel like not much progress has been made in general practice policy in the three decades between them" – @JenniferDoggett
croakey.org/are-we-there-y…
croakey.org/are-we-there-y…
"Traditional Owners, health researchers, doctors and concerned community members have called for real-time ambient air quality monitoring to be undertaken and for data to be made publicly available" – @Jade_Braddy
croakey.org/investigating-…
croakey.org/investigating-…
Now to put the spotlight on @COHealth - who have been a fantastic supporter of @CroakeyNews from soon after we first set up as a non profit organisation. Read more about their work here: cohealth.org.au #AppreciationDay #HealthEquityMatters2023 #CroakeyFundingDrive
Why might a community health service support public interest journalism? Perhaps because @COHealth has a holistic view of health & works for health equity. As they say: "We pursue health & social equity through care for individuals, care for community & care for society."
At @CroakeyNews, we also value @COHealth's interest in contributing to public debate about health. So often this is driven by powerful professional/commercial interests; community health sector brings impt perspectives that are impt for addressing health equity concerns #SDOH
Hello! @AlisonSBarrett here – I'll be live-tweeting @CroakeyNews second post-Budget webinar from Kaurna Country.
It is due to begin at 5pm AEDT.
There is still a bit of time to register – details below!
croakey.org/with-media-ref…
It is due to begin at 5pm AEDT.
There is still a bit of time to register – details below!
croakey.org/with-media-ref…
Health in all policies is the focus of tonight's webinar.
@SummerMayFinlay is moderating tonight's discussion. Summer is a Yorta Yorta woman, Croakey contributing editor & Senior Lecturer Wollongong University.
Following is an intro to the other speakers..
#WellbeingBudget2022
@SummerMayFinlay is moderating tonight's discussion. Summer is a Yorta Yorta woman, Croakey contributing editor & Senior Lecturer Wollongong University.
Following is an intro to the other speakers..
#WellbeingBudget2022
We hear it often: "Kaiser spends $50M on housing," "United HC donates $3M to food security..." so we asked, how much are private insurers REALLY spending on #SDOH?
Our work in @JournalGIM attempts to answer this Q -- you may or may not be surprised.
link.springer.com/article/10.100…
1/x
Our work in @JournalGIM attempts to answer this Q -- you may or may not be surprised.
link.springer.com/article/10.100…
1/x
After identifying social spending for the top 20 US health insurers by market share (66%+ of the total market), we found that:
1. đź’° Bw 2017-2021, social spending was at least $1.87 billion
2. 🏩 The top 6 insurers made up nearly 3/4 of that spending
2/x
1. đź’° Bw 2017-2021, social spending was at least $1.87 billion
2. 🏩 The top 6 insurers made up nearly 3/4 of that spending
2/x
3. 🏡 Most funds ($1.2B) went to housing and food security ($238M) programs
4. đźš— The fewest funds ($13.4M) went to transportation
You may be wondering -- did Covid-19 impact spending? It certainly appears so.
Funding for nearly all SDOH categories spiked in 2020...
3/x
4. đźš— The fewest funds ($13.4M) went to transportation
You may be wondering -- did Covid-19 impact spending? It certainly appears so.
Funding for nearly all SDOH categories spiked in 2020...
3/x
What might the Jobs & Skills Summit mean for health? The @CroakeyNews bulletin this week has a series addressing this very question. HT @MiriamDVDBerg for showing the way forward for #HealthEquity at #JobsSummit2022 croakey.org/putting-health… #AusPol
Here are @MiriamDVDBerg recommendations to #JobsSummit2022, based around the five themes put forward by @JEChalmers et al #AusPol cc @_PHAA_ @SandroDemaio @VicHealth @baumfran @SharonFrielOz @Mark_Butler_MP #SDOH
Five ways the Jobs and Skills Summit can help address our healthcare needs – By Kylie Woolcock of @AusHealthcare croakey.org/five-ways-the-… #AusPol #HealthReform #CoherentStrategy #JobsSummit2022
There's a lot in this thread, but one pt I'd like to extract is connected to something I've been arguing for years and #onhere quite a bit recently:
#MethodologicalIndividualism in public health occurs where we position the individual as the unit of change.
1/
#MethodologicalIndividualism in public health occurs where we position the individual as the unit of change.
1/
This is in comparison to structural interventions, which often alter upstream factors and institutions. My favorite example of the latter is laws and policies, but can also include infrastructure and built environmental changes, etc.
2/
2/
But leading public health officials in the US have completely followed the #MethodologicalIndividualism that has dominated public health policy and priorities for much of the 20th c. until now. See:
pubmed.ncbi.nlm.nih.gov/19965565/
3/
pubmed.ncbi.nlm.nih.gov/19965565/
3/
The impact of #racism on maternal health & early life #RHOConf22
@LaurieZephyrin
Systemic & structural determinants of health & effect of #intersectionality for women of colour #SDOH
Black mothers more likely to die than white mothers for >100yrs
The five whys as a framework
@LaurieZephyrin
Systemic & structural determinants of health & effect of #intersectionality for women of colour #SDOH
Black mothers more likely to die than white mothers for >100yrs
The five whys as a framework
#RHOConf22 the landscape is changing
@LaurieZephyrin
Imp of community partners, integration of social needs - new opportunities for the #ICS
Introducing panel @TeamCMidO, Dr Daghni Rajasingam, @MumsandTea and @BenashNaz đź’™
Take the woman with you & have the will to act
@LaurieZephyrin
Imp of community partners, integration of social needs - new opportunities for the #ICS
Introducing panel @TeamCMidO, Dr Daghni Rajasingam, @MumsandTea and @BenashNaz đź’™
Take the woman with you & have the will to act
Data obscures the human experience
Strategy based on #ProportionateUniversalism at scale and intensity equal to the level of need
Focus on #racist behaviour and who listens to who @TeamCMidO
@MumsandTea recommends data sets and ethnic coding “what gets measured gets done”
Strategy based on #ProportionateUniversalism at scale and intensity equal to the level of need
Focus on #racist behaviour and who listens to who @TeamCMidO
@MumsandTea recommends data sets and ethnic coding “what gets measured gets done”
The @NHS_RHO is a do-tank not a think-tank #RHOConf22.
It’s a place where things get done @Voa1234
How an org values it’s ethnic minority staff is a good barometer of how well patients are likely to feel irrespective of skin colour
It’s about #leadership
It’s a place where things get done @Voa1234
How an org values it’s ethnic minority staff is a good barometer of how well patients are likely to feel irrespective of skin colour
It’s about #leadership
Now @DrHNaqvi starting with a quote from #JRRTolkein #RHOConf22
We must break down #inequalities
The @NHS_RHO set up to:
Synthesise insight
Inform policy
Enable transformation
Work programme uses global data driven evidence
Year 1 report:
tinyurl.com/4znax229
We must break down #inequalities
The @NHS_RHO set up to:
Synthesise insight
Inform policy
Enable transformation
Work programme uses global data driven evidence
Year 1 report:
tinyurl.com/4znax229
What drives racial inequities? @D_R_Williams1 #RHOConf22
Socioeconomic status SES matters
In the UK for every ÂŁ1 a white person has, a Black/Bangladeshi has 10p
But after SES taken into account, it’s about race
Not about “trying harder”
Neighbourhood opportunity matters
#Racism
Socioeconomic status SES matters
In the UK for every ÂŁ1 a white person has, a Black/Bangladeshi has 10p
But after SES taken into account, it’s about race
Not about “trying harder”
Neighbourhood opportunity matters
#Racism
A2 #Latinos are 1.5X as likely to be affected by #ALZ than non-Latino whites. They face inequities that discourage healthcare participation. They’re less likely to receive a timely diagnosis & more likely to experience #racism. #BrainHealthEquity #SaludTues @UsAgainstAlz (1/3)
A2 continued: In addition to barriers in healthcare participation, #Latinos & other people of color face higher risk for #ALZ or related dementia due to due to higher risk of comorbidities, like #diabetes and #hypertension. #BrainHealthEquity #SaludTues @UsAgainstAlz (2/3)
A2 continued: Lastly, social determinants of health #SDOH, like educational attainment, obesity & pollution are disproportionately felt by #Latino communities. We must make an intentional effort to promote #prevention & #BrainHealthEquity for #Latinos #SaludTues @UsAgainstAlz 3/3
Panel discussion up now: 'reframing Aboriginal health as the key to our future of health' with panel facilitated by Nicole McCartney, Chief Aboriginal Health Advisor at DOH Victoria. #GiantSteps22
Panelists incl Brad Brown, Director Victorian Aboriginal Health Service, Sheree Lowe Executive Director of Social & Wellbeing Centre of Excellence @VACCHO_org & Pat Turner AM CEO @NACCHOAustralia - #GiantSteps22
Question - why is it important to reframe health?
Brown - local people talk about their own issues & needs, as needs & #SDOH are different across communities. Co-producing is important - community is part of the process, which is part of self-determination also #GiantSteps22
Brown - local people talk about their own issues & needs, as needs & #SDOH are different across communities. Co-producing is important - community is part of the process, which is part of self-determination also #GiantSteps22
I'm catching up on some of the recorded sessions & will start a thread on the 'Impact of the UN Committee’s statement in 2019 in relation to the minimum age of criminal responsibility', one of #RANZCP2022's recorded sessions, presented by Invited speaker Dr Enys Delmage
Dr Delmage is a consultant in adolescent forensic psychiatry and has worked in an adolescent forensic inpatient unit in Porirua, New Zealand, since November 2017. He has an interest in the law as it relates to children.ranzcp2022.com.au/dr-enys-delmage #RANZCP2022
Minimum age of criminal responsibility is defined as the age below which is deemed incapable of having committed a criminal offence. Below this age, children are 'doli incapax' - incapable of knowing that what they were doing was wrong- Dr Delmage #RANZCP2022
Well that was truly awesome. A presentation from a medical student Maddie Pritchard from Aberdeen on the effects of social deprivation on outcomes for frail older patients.
A complex subject! #bgsconf #SDOH (social determinants of health).
A complex subject! #bgsconf #SDOH (social determinants of health).
I’ll tweet some of Maddie’s graphs. Some fascinating results, that aren’t straightforward to explain….
#bgsconf
#bgsconf
Next up at the #bgsconf meeting is @GrahamEllis247, talking about the Older People’s Strategy.
How do we address the health inequalities that afflict our country so badly?
#SDOH #inequality
How do we address the health inequalities that afflict our country so badly?
#SDOH #inequality
So many challenges. Older people are often discriminated against and yet are also often quite passive in accepting what they experience.
#bgsconf
#bgsconf
Building on my thread below, I want to help policymakers committed to social, economic and climate justice better understand not only why #Bitcoin's proof-of-work consensus is essential, but Bitcoin's global value. We need policymakers to adopt a "walk and chew gum" approach. 🧵
2/ What I mean by a "walk and chew gum" approach is to step back from the fragmented silos in which public policy is far too often approached these days -- environment | housing | healthcare | food security | education | others -- and to adopt an inter-sectoral lens on #Bitcoin.
@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 3/ Social determinants of health #SDOH
👉Conditions in places where people live, learn, work, & play shaped by 💰wealth, power, & resources that affect a wide range of health risks/outcomes
đź“ŚSDOH can lead to unfair & avoidable differences in health status w/in pops #disparities
👉Conditions in places where people live, learn, work, & play shaped by 💰wealth, power, & resources that affect a wide range of health risks/outcomes
đź“ŚSDOH can lead to unfair & avoidable differences in health status w/in pops #disparities
@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 4/ #SDOH impact health outcomes
📌Unemployed >6yrs👉2x⬆️mortality
📌Chicago area👉16yrs⬇️ life expectancy
📌Social isolation👉2x⬆️ risk of CAD
📌Unsafe childhood👉5x⬆️risk mental health disorder
📌Dual M/M ins👉24%-67% ⬆️readmission
📌Language services👉60% ⬆️risk ED utilization
📌Unemployed >6yrs👉2x⬆️mortality
📌Chicago area👉16yrs⬇️ life expectancy
📌Social isolation👉2x⬆️ risk of CAD
📌Unsafe childhood👉5x⬆️risk mental health disorder
📌Dual M/M ins👉24%-67% ⬆️readmission
📌Language services👉60% ⬆️risk ED utilization
@MondayNightIBD @DCharabaty @BonumCe @pfizer @JanssenUS @TakedaPharma 5/ How do #SDOH impact pts w/ #IBD?
📌 Low socioeconomic status (SES) in pts w/ IBD 👉
⬆️ICU admissions
⬆️hospitalizations 🏥
⬆️mortality risk
⬆️use of steroids >2,000mg/yr
⬆️outpatient visits
⬆️narcotic/psych med use
#MondayNightIBD
📌 Low socioeconomic status (SES) in pts w/ IBD 👉
⬆️ICU admissions
⬆️hospitalizations 🏥
⬆️mortality risk
⬆️use of steroids >2,000mg/yr
⬆️outpatient visits
⬆️narcotic/psych med use
#MondayNightIBD
Ce que décrit ce tweet est un phénomène découlant du Santéisme ou Healthism.
Mot que j'ai découvert grâce à Carla Nagels, qui s'appuie sur ce concept pour expliquer les dérives de l'autonomisation du citoyen et l'émergence des pratiques anti-scientifiques et antivax.
⤵️🧵
Mot que j'ai découvert grâce à Carla Nagels, qui s'appuie sur ce concept pour expliquer les dérives de l'autonomisation du citoyen et l'émergence des pratiques anti-scientifiques et antivax.
⤵️🧵
Il n'y a pas bcp d'articles en médecine sur le sujet.
74 results PubMed
Il surgit en 1980 dans l'article d'un Ă©conomiste "Healthism and the medicalization of everyday life"
qui pose déjà les pièges de l'injonction au bien-être plaçant l'individu au centre
pubmed.ncbi.nlm.nih.gov/7419309/
74 results PubMed
Il surgit en 1980 dans l'article d'un Ă©conomiste "Healthism and the medicalization of everyday life"
qui pose déjà les pièges de l'injonction au bien-être plaçant l'individu au centre
pubmed.ncbi.nlm.nih.gov/7419309/
"Dans la mesure où le Santéisme façonne les croyances populaires, nous continuerons à avoir une conception et une stratégie de promotion de la santé apolitiques et donc, en fin de compte, inefficaces"
BOUM!
Et Robert Crowford a Ă©crit cela il y a 42 ans.
42 fucking années.
BOUM!
Et Robert Crowford a Ă©crit cela il y a 42 ans.
42 fucking années.
I see that we are still slavishly worshipping at the idol of RCTs in epidemiologic science as the evidentiary warrant for public health action. I have written LOTS on the foolishness of this, its disastrous ethical & policy implications, & it's role in #ManufactureOfDoubt.
1/
1/
It's almost as if people have never heard of the #PrecautionaryPrinciple. If we demanded evidence of exposure-harm or intervention-benefit that flowed from RCTs to warrant public health interventions, we would have essentially NO public health action AT ALL.
2/
2/
More on this, from my 2016 paper on importance of maintaining epistemically reasonable standards for proof of harm (& benefit!) as warrant for public health action:
(The subject of the paper is COIs and lays out my arg for regarding them as ordinary epidemiologic exposures)
3/
(The subject of the paper is COIs and lays out my arg for regarding them as ordinary epidemiologic exposures)
3/
#antivaxx efforts now even use #deepfake
to target #refugee, Black, religious minority communities
like measles outbreak in Minnesota in 2019: Wakefield was flown in TO spread #misinformation & #disinformation
Now: online fake accounts/fake identities vs #VaccinesWork
to target #refugee, Black, religious minority communities
like measles outbreak in Minnesota in 2019: Wakefield was flown in TO spread #misinformation & #disinformation
Now: online fake accounts/fake identities vs #VaccinesWork
What has #healthcare been doing meanwhile?
#Medbikini: Teach (male Asian) med students to make fake accounts to cyberstalk trainees’ personal Facebook for: bikini
or “being political” or “religious” (#BLM)
➡️“model minority” pipeline for “shadow faculty” vs Blck @ayshakhoury
#Medbikini: Teach (male Asian) med students to make fake accounts to cyberstalk trainees’ personal Facebook for: bikini
or “being political” or “religious” (#BLM)
➡️“model minority” pipeline for “shadow faculty” vs Blck @ayshakhoury
#Medbikini #research got flak for men vs women
BUT was ALSO fake acct #surveillance vs #BLM like drove out @ayshakhoury @uche_blackstock @nhannahjones
While academia has ignored #vaccineequity
➡️ongoing #pandemic & deaths in marginalized targeted by #antivaxx
@womanistpsych
BUT was ALSO fake acct #surveillance vs #BLM like drove out @ayshakhoury @uche_blackstock @nhannahjones
While academia has ignored #vaccineequity
➡️ongoing #pandemic & deaths in marginalized targeted by #antivaxx
@womanistpsych
🔥Off the press: focused review on #race #ethnicity #hypertension #heartdisease w @KcfMd @ycommodore @JACCJournals #healthequity #bloodpressure #HTNroundtable #HTN80 #CardioTwitter #medtwitter @HHSGov @Surgeon_General @HeartNews @ABCardio1 @ACCinTouch
bit.ly/3rTMDG4
bit.ly/3rTMDG4
đź©ş#hypertension is the leading preventable #riskfactor for #heartdisease & #stroke
đź©ş#hypertension is a major contributor to #racial & #ethnic #disparities in #cardiovasculardisease
đź©ş#hypertension rates among #Black adults are one of the highest rates of globally
#HTNroundtable
đź©ş#hypertension is a major contributor to #racial & #ethnic #disparities in #cardiovasculardisease
đź©ş#hypertension rates among #Black adults are one of the highest rates of globally
#HTNroundtable
đź©ş#hypertension #control remains a persistent #clinical problem & #publichealth #challenge
đź©şWe must eliminate these #disparities in #HTN and address #barriers to #hypertensioncontrol
đź©ş#HTN80 #HTNroundtable #HealthEquity #bloodpressure #hypertensioncontrol
đź©şWe must eliminate these #disparities in #HTN and address #barriers to #hypertensioncontrol
đź©ş#HTN80 #HTNroundtable #HealthEquity #bloodpressure #hypertensioncontrol
