The Urban Institute acts as the National Coordinating Center and is a research hub for Policies for Action (P4A), a signature program of the Robert Wood Johnson Foundation. P4A collaborates with experts and scholars across multiple disciplines to shed light on how social-sector policies and laws—in health care, housing, nutrition, transportation, urban planning, education, criminal justice, and more—support or undermine population health, well-being, and equity. P4A is building a robust, actionable evidence base on how policies, laws, and other levers, including those in the private sector, can advance a Culture of Health, with a goal of delivering these data and insights to key policymakers, community leaders, and other change agents.
Everyone should have the opportunity to achieve good health. But, as Dr. Camara Phyllis Jones explains through her cliff analogy, that's often not the case. We can reduce health disparities and better connect people to high-quality medical care, but to really make a difference, we need to address the social determinants of health and equity that protect some people and push others off the cliff.
The Urban Institute collaborated with Janice Nittoli practitioner fellow Manmeet Kaur, CEO and founder of City Health Works, to apply practical insights and data to improve health care and address the social determinants of health. Products of the partnership with the Harlem-based community health organization include a video highlighting City Health Works’ client and coach perspective, a research brief about what patients with diabetes think of health coaching, a video showing how City Health Works fills a gap in chronic care, and an event on community health worker models in managing chronic conditions.
The United States spends nearly twice as much per person on health care as other rich nations, but we’re no healthier for it. To understand why, we need to broaden our picture of health. Health is driven by much more than what happens in the doctor’s office, so our health problems can’t be solved by health care alone. This feature uses photo essays, personal narratives, and documentary film techniques to peel back the layers of the many factors that play a role in our health.
Improving Health through Housing
Lack of safe, affordable housing can contribute to poor physical and mental health, higher use of emergency and hospital services, and increased public health care costs. Researchers at Urban have been studying strategies to address health through housing, building the evidence base for approaches that work. "Emerging Strategies for Integrating Health and Housing" examines emerging interventions that integrate housing and health services for low-income people, and "Fostering Collaboration in Housing and Health" studies how health care reforms help states, localities, and organizations integrate housing and health care delivery.
The opioid epidemic is a public health emergency that is part of a larger problem of untreated substance use disorder in both rural and urban areas in the United States. By drawing on Urban experts from the health, justice, and safety net policy fields, we are uniquely positioned to detect emerging problems and risks, monitor policy changes, and identify and evaluate innovative solutions. Our ability to work across disciplines is one of Urban’s key strengths and allows us take a comprehensive approach to tackling this issue on multiple fronts.
State and local policy decisions can significantly affect disease rates, life expectancy, and the cost of health care—even when those decisions are not directly tied to health policy. Through this project, we analyze state-level data on health systems, health behaviors, social and economic factors, the physical and social environment, and public policies. We use that information to catalog the health status of the states. We also feature select US cities to show that similar influences shape health outcomes locally.
Working in collaboration with Virginia Commonwealth University’s Center on Society and Health, we are delving into the powerful connections between income and health. The biggest differences in disease rates and life expectancy are less about the medical care we get from doctors and hospitals and more about our social status, including our jobs, income, and wealth. The health implications of these factors are so large that economic policies may be more important to public health than any kind of health care reform.
With support from the the John D. and Catherine T. MacArthur Foundation, the Urban Institute curates research exploring how access to high-quality, affordable housing can strengthen families and revitalize communities. Through the the How Housing Matters website, we hope to encourage practice and policy innovations that facilitate collaboration among leaders and policymakers in housing, education, health and economic development. The ultimate goal is to better and more cost-effectively help families lead healthy, successful lives.