BU-Led Global Commission Launches Roadmap to Better Health
The Rockefeller Foundation-BU Commission on Health Determinants, Data, and Decision-making released a groundbreaking report that details principles and recommendations for advancing health equity through evidence-based policymaking.
Social determinants of health—the factors that shape where we live, work, learn, and play, from stable employment and housing to food access, education, and policies and laws—impact our health in many more ways than a doctor can.
These determinants matter, and a data-driven understanding of how and why they matter can lead to better decision-making toward policies that will improve population health, according to a new report by the Rockefeller Foundation-Boston University Commission on Health Determinants, Data, and Decision-Making (3-D Commission).
The commission released its groundbreaking report, titled Data, Social Determinants, and Better Decision-Making for Health: The Report of the 3-D Commission, during a virtual event Tuesday, September 21, designed to coincide with this week’s 76th United Nations General Assembly in New York. Held on Zoom, the launch featured opening remarks by Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO) and Naveen Rao, senior vice president of the health initiative at The Rockefeller Foundation, as well as a discussion of the report findings with six Commission members, moderated by Sandro Galea, School of Public Health dean and Robert A. Knox Professor, and chair of the 3-D Commission.
The comprehensive report is a culmination of nearly two years of exploration and analysis by the 25-member commission of experts in public health and data science. The 3-D Commission was created in early 2019—well before the start of the COVID-19 pandemic—to explore how the rapid increase in big data could be leveraged to measure social determinants more effectively and foster better decision-making around health. The pandemic quickly brought to the forefront that social, economic, and health determinants and inequities are inextricably linked, making the work of the commission all the more urgent.
“The COVID-19 pandemic is a reminder both of our interconnectedness, and of the longstanding structural drivers of health inequities,” said Ghebreyesus in video remarks at the start of the event. “Real-time data is essential for understanding what makes people healthier or sicker, and to shape policy decisions to support countries to progress towards these sustainable development goals.”
The public has witnessed firsthand the difference that accurate data can make in responding to a threat and protecting people’s health, Rao said. The Rockefeller Foundation partnered with the COVID-19 Tracking Project to better understand how the virus was spreading and which communities were most affected, which led to improved COVID-19 testing among the Navajo Nation. The foundation’s new Pandemic Prevention Institute will leverage traditional and nontraditional data—such as Google Search analyses or purchasing and travel data—to anticipate, detect, and track new health threats.
“Non-health data can also show us important trends,” said Rao. “For example, an uptick in medicine sales in one community tells us that it may be dealing with more illnesses than usual, possibly a significant new outbreak.
“Your phone can already tell you to carry an umbrella, because it’s going to rain. What if it could also say when to wear masks to prevent sickness? That is the power of data in pandemic prevention.”
The 3-D Commission report embraces a “whole-of-society” approach to address the root causes of health inequities and improve population health, Galea said. In the report, the Commission urges policymakers, the private sector, and local community organizations to consider the “full spectrum of social determinants of health” when thinking about what drives health, including policy decisions at the local, national, and global levels, religion and culture, the environment, education, and economic opportunities. It also identifies a series of principles and actionable recommendations that will enable all stakeholders to collect and learn from data, and implement effective, sustainable health policies.
“We saw in this COVID moment how decisions about essential work, transportation, and housing and eviction fundamentally influenced whether or not people developed COVID, got severe COVID, or died from COVID,” Galea said.
Referencing the plethora of misinformation currently surrounding COVID-19 vaccines, he noted the importance of gaining trust from communities on data to effectively implement evidence-informed policies.
“Collecting data to inform our understanding of social determinants, to the end of making better decisions, would end up being fruitless without population trust in those data and decision-makers intentions’ to promote health,” Galea said.
Political will is also essential in developing health policies that directly and accurately reflect the community, said Laura Magaña, president and chief executive officer of the Association of Schools and Programs of Public Health, and a member of the 3-D Commission. ”Decision-makers often take action based on their own knowledge, experience, and positions in society, even though their personal realties may be vastly different from individuals within the community.” Instead, she said, decision-makers should “seek meaningful engagement with the community.”
“The 3-D Commission set out to advance a transdisciplinary agenda at the intersection of social determinants of health and big data to the end of improving decision-making around health,” said Salma Abdalla (SPH’16), research fellow and doctoral student, and the 3-D Commission’s lead project director, prior to the launch. “Achieving a healthier world built on trust will require a commitment to the centrality of health equity, an expansive perspective on data, an acknowledgment that context matters, a shared culture of data-informed decision-making, a commitment to accountability, and honoring communities’ lived experiences and perspectives.”
Leading up to the launch of the report, the 3-D Commission held several virtual conversations with global leaders in public health and data science. In the coming weeks, the Commission will host a series of public, virtual launch events with regional partners in the Middle East 11 a.m.-noon on Monday, Sept. 27; the Americas 3-4 p.m. Tuesday, Sept. 28; Asia 10:30-11:30 p.m. Sept. 28; in Africa 8-9 a.m. Friday, Oct. 1; and Europe 8-9 a.m. Tuesday, Oct. 5 (all EST). All events are free and open to the public. To view all past 3-D conversations, click here.