A comprehensive review of U.S. social policies evaluated for their health outcomes found suggestive evidence that early life, income, and health insurance interventions have the potential to improve health. Until this study, there was little research carried out to understand whether it was possible to improve population health by addressing risk factors like poverty with social policies. Findings are published in The Milbank Quarterly, a journal published by the Milbank Memorial Fund.
“Since the 1960s, a large number of social policies that have been experimentally evaluated include health outcomes, but these were mostly overlooked. By tracking down these studies, we found a unique opportunity to inform evidence-based policymaking,” said Dr. Peter Muennig, professor of health policy and management at Columbia University Mailman School of Public Health
The review of all known randomized social experiments in the U.S. that involved health outcomes included 5,876 papers, reports, and data sources, ultimately encompassing 60 from 38 randomized social experiments, spanning 1962–2018 and featured a range of policies, analytic approaches, and target groups and measured a wide variety of health outcomes.
The final analysis was based on 450 unique health estimates across the 38 interventions. Among those from which reliable estimates could be obtained, 49 percent demonstrated a significant health improvement, 44 percent had no effect on health, and 7 percent were associated with significant worsening of health.
Income support and health insurance programs showed the most promise in improving population health.
“Our study is exciting because it shows for the first time that it is possible for the government to improve health by making investments outside of the health system.”Friday Letter Submission, Publish on March 27