{"id":{"repo_id":"bu","oai_identifier":"oai:open.bu.edu:2144/45078"},"canonical_url":"https://search.dev.ndltd.org/etd/bu/oai:open.bu.edu:2144/45078","repository":{"repo_id":"bu","name":"Boston University","base_url":"https://open.bu.edu/oai/request"},"display":{"title":"Creating healthier populations: an assessment of the use of data on social determinants of health to inform decision-making in eight countries","abstract":"BACKGROUND: This work serves as a cases study for the findings of the Rockefeller Foundation-Boston University Commission on Health Determinants, Data, and Decision-Making (3-D Commission). The dissertation assessed public views of what matters for health, the degree of incorporation of SDoH in Covid-19 decision-making, and the mental health consequences of SDoH disruptions in diverse contexts using multiple data sources. METHODS: An online survey collected relevant individual-level data from Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States using RIWI—a professional global survey platform that uses a patented Random Domain Intercept Technology™ (RDIT™). National-level data retrieved included Covid-19 policy data from the Oxford Covid-19 Government Response Tracker (OxCGRT) and data from the International Labour Organization (ILO) on the informal labor sector. All data were used in descriptive and multivariable regression analyses. RESULTS: Of 8,754 respondents, 56.2% (95% CI: 55.1%, 57.2%) ranked healthcare as the most important determinant of health. Politics was the determinant with the greatest absolute difference between what respondents considered matters for health versus what they perceived decision-makers think matters for health. Overall, more restrictive Covid-19 stay-at-home orders were associated with a higher burden of SDoH disruptions while more expansive income support policies were associated with a lower burden of disruptions. The lowest two income quintile in all countries reported the highest burden of employment insecurity, financial insecurity, and food/supplies insecurity. The income gradient of SDoH disruptions persisted after controlling for government income support policies. Experiencing Covid-19 SDoH disruptions was then associated with a higher burden of both depression symptoms and probable post-traumatic stress disorder (PTSD). The prevalence of probable PTSD was about three times higher among people who experienced at least one Covid-19 SDoH disruption compared to those who did not experience a disruption. CONCLUSION: This research showcases the need for more investment in communication efforts around the importance of SDoH both to the general public and decision-makers. Moreover, SDoH disruptions and their association with adverse mental health outcomes during the Covid-19 pandemic highlight the lack of consideration for SDoH in the design and implementation of policies. Countries in different contexts would benefit from implementing the 3-D Commission principles and recommendations to ensure that decision-making on health is guided by equity and informed by data on SDoH.","abstract_html":"BACKGROUND: This work serves as a cases study for the findings of the Rockefeller Foundation-Boston University Commission on Health Determinants, Data, and Decision-Making (3-D Commission). The dissertation assessed public views of what matters for health, the degree of incorporation of SDoH in Covid-19 decision-making, and the mental health consequences of SDoH disruptions in diverse contexts using multiple data sources. METHODS: An online survey collected relevant individual-level data from Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States using RIWI—a professional global survey platform that uses a patented Random Domain Intercept Technology™ (RDIT™). National-level data retrieved included Covid-19 policy data from the Oxford Covid-19 Government Response Tracker (OxCGRT) and data from the International Labour Organization (ILO) on the informal labor sector. All data were used in descriptive and multivariable regression analyses. RESULTS: Of 8,754 respondents, 56.2% (95% CI: 55.1%, 57.2%) ranked healthcare as the most important determinant of health. Politics was the determinant with the greatest absolute difference between what respondents considered matters for health versus what they perceived decision-makers think matters for health. Overall, more restrictive Covid-19 stay-at-home orders were associated with a higher burden of SDoH disruptions while more expansive income support policies were associated with a lower burden of disruptions. The lowest two income quintile in all countries reported the highest burden of employment insecurity, financial insecurity, and food/supplies insecurity. The income gradient of SDoH disruptions persisted after controlling for government income support policies. Experiencing Covid-19 SDoH disruptions was then associated with a higher burden of both depression symptoms and probable post-traumatic stress disorder (PTSD). The prevalence of probable PTSD was about three times higher among people who experienced at least one Covid-19 SDoH disruption compared to those who did not experience a disruption. CONCLUSION: This research showcases the need for more investment in communication efforts around the importance of SDoH both to the general public and decision-makers. Moreover, SDoH disruptions and their association with adverse mental health outcomes during the Covid-19 pandemic highlight the lack of consideration for SDoH in the design and implementation of policies. Countries in different contexts would benefit from implementing the 3-D Commission principles and recommendations to ensure that decision-making on health is guided by equity and informed by data on SDoH.","abstract_has_math":false,"creators":["Abdalla, Salma M."],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Galea, Sandro"],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022","date_published":"2022","updated_at":"2026-07-24T01:23:54Z","subjects":["Public health","Employment","Food security","Global health","Mental health","Public policy","Social determinants of health"],"languages":["en_US"],"rights":["Attribution-NonCommercial-NoDerivatives 4.0 International"],"rights_urls":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2144/45078","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Galea, Sandro"]},{"key":"dc:creator","label":"Author","values":["Abdalla, Salma M."]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2022-09-06T20:05:40Z"]},{"key":"dc:date.issued","label":"Date","values":["2022"]},{"key":"dc:type","label":"Dc Type","values":["Thesis/Dissertation"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Public health","Employment","Food security","Global health","Mental health","Public policy","Social determinants of health"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en_US"]},{"key":"dc:rights","label":"Dc Rights","values":["Attribution-NonCommercial-NoDerivatives 4.0 International"]},{"key":"dc:rights.uri","label":"Rights URI","values":["http://creativecommons.org/licenses/by-nc-nd/4.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/2144/45078"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["BACKGROUND: This work serves as a cases study for the findings of the Rockefeller Foundation-Boston University Commission on Health Determinants, Data, and Decision-Making (3-D Commission). The dissertation assessed public views of what matters for health, the degree of incorporation of SDoH in Covid-19 decision-making, and the mental health consequences of SDoH disruptions in diverse contexts using multiple data sources. METHODS: An online survey collected relevant individual-level data from Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States using RIWI—a professional global survey platform that uses a patented Random Domain Intercept Technology™ (RDIT™). National-level data retrieved included Covid-19 policy data from the Oxford Covid-19 Government Response Tracker (OxCGRT) and data from the International Labour Organization (ILO) on the informal labor sector. All data were used in descriptive and multivariable regression analyses. RESULTS: Of 8,754 respondents, 56.2% (95% CI: 55.1%, 57.2%) ranked healthcare as the most important determinant of health. Politics was the determinant with the greatest absolute difference between what respondents considered matters for health versus what they perceived decision-makers think matters for health. Overall, more restrictive Covid-19 stay-at-home orders were associated with a higher burden of SDoH disruptions while more expansive income support policies were associated with a lower burden of disruptions. The lowest two income quintile in all countries reported the highest burden of employment insecurity, financial insecurity, and food/supplies insecurity. The income gradient of SDoH disruptions persisted after controlling for government income support policies. Experiencing Covid-19 SDoH disruptions was then associated with a higher burden of both depression symptoms and probable post-traumatic stress disorder (PTSD). The prevalence of probable PTSD was about three times higher among people who experienced at least one Covid-19 SDoH disruption compared to those who did not experience a disruption. CONCLUSION: This research showcases the need for more investment in communication efforts around the importance of SDoH both to the general public and decision-makers. Moreover, SDoH disruptions and their association with adverse mental health outcomes during the Covid-19 pandemic highlight the lack of consideration for SDoH in the design and implementation of policies. Countries in different contexts would benefit from implementing the 3-D Commission principles and recommendations to ensure that decision-making on health is guided by equity and informed by data on SDoH."]},{"key":"dc:title","label":"Title","values":["Creating healthier populations: an assessment of the use of data on social determinants of health to inform decision-making in eight countries"]}]}],"canonical_facts":{"dc:contributor.advisor":["Galea, Sandro"],"dc:creator":["Abdalla, Salma M."],"dc:date.accessioned":["2022-09-06T20:05:40Z"],"dc:date.issued":["2022"],"dc:description.abstract":["BACKGROUND: This work serves as a cases study for the findings of the Rockefeller Foundation-Boston University Commission on Health Determinants, Data, and Decision-Making (3-D Commission). The dissertation assessed public views of what matters for health, the degree of incorporation of SDoH in Covid-19 decision-making, and the mental health consequences of SDoH disruptions in diverse contexts using multiple data sources. METHODS: An online survey collected relevant individual-level data from Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States using RIWI—a professional global survey platform that uses a patented Random Domain Intercept Technology™ (RDIT™). National-level data retrieved included Covid-19 policy data from the Oxford Covid-19 Government Response Tracker (OxCGRT) and data from the International Labour Organization (ILO) on the informal labor sector. All data were used in descriptive and multivariable regression analyses. RESULTS: Of 8,754 respondents, 56.2% (95% CI: 55.1%, 57.2%) ranked healthcare as the most important determinant of health. Politics was the determinant with the greatest absolute difference between what respondents considered matters for health versus what they perceived decision-makers think matters for health. Overall, more restrictive Covid-19 stay-at-home orders were associated with a higher burden of SDoH disruptions while more expansive income support policies were associated with a lower burden of disruptions. The lowest two income quintile in all countries reported the highest burden of employment insecurity, financial insecurity, and food/supplies insecurity. The income gradient of SDoH disruptions persisted after controlling for government income support policies. Experiencing Covid-19 SDoH disruptions was then associated with a higher burden of both depression symptoms and probable post-traumatic stress disorder (PTSD). The prevalence of probable PTSD was about three times higher among people who experienced at least one Covid-19 SDoH disruption compared to those who did not experience a disruption. CONCLUSION: This research showcases the need for more investment in communication efforts around the importance of SDoH both to the general public and decision-makers. Moreover, SDoH disruptions and their association with adverse mental health outcomes during the Covid-19 pandemic highlight the lack of consideration for SDoH in the design and implementation of policies. Countries in different contexts would benefit from implementing the 3-D Commission principles and recommendations to ensure that decision-making on health is guided by equity and informed by data on SDoH."],"dc:identifier.uri":["https://hdl.handle.net/2144/45078"],"dc:language.iso":["en_US"],"dc:rights":["Attribution-NonCommercial-NoDerivatives 4.0 International"],"dc:rights.uri":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"dc:subject":["Public health","Employment","Food security","Global health","Mental health","Public policy","Social determinants of health"],"dc:title":["Creating healthier populations: an assessment of the use of data on social determinants of health to inform decision-making in eight countries"],"dc:type":["Thesis/Dissertation"]},"updated_at":"2026-07-24T01:23:54Z"}