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Addressing population health and health inequalities: The role of fundamental causes

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  • Cerdá, M.
  • Tracy, M.
  • Ahern, J.
  • Galea, S.

Abstract

Objectives. As a case study of the impact of universal versus targeted interventions on population health and health inequalities, we used simulations to examine (1) whether universal or targeted manipulations of collective efficacy better reduced population-level rates and racial/ethnic inequalities in violent victimization; and (2) whether experiments reduced disparities without addressing fundamental causes. Methods. We applied agent-based simulation techniques to the specific example of an intervention on neighborhood collective efficacy to reduce populationlevel rates and racial/ethnic inequalities in violent victimization. The agent population consisted of 4000 individuals aged 18 years and older with sociodemographic characteristics assigned to match distributions of the adult population in New York City according to the 2000 US Census. Results. Universal experiments reduced rates of victimization more than targeted experiments. However, neither experiment reduced inequalities. To reduce inequalities, it was necessary to eliminate racial/ethnic residential segregation. Conclusions. These simulations support the use of universal intervention but suggest that it is not possible to address inequalities in health without first addressing fundamental causes.

Suggested Citation

  • Cerdá, M. & Tracy, M. & Ahern, J. & Galea, S., 2014. "Addressing population health and health inequalities: The role of fundamental causes," American Journal of Public Health, American Public Health Association, vol. 104(S4), pages 609-619.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302055_7
    DOI: 10.2105/AJPH.2014.302055
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    Cited by:

    1. Maeve E. Wallace & Carmen Green & Lisa Richardson & Katherine Theall & Joia Crear-Perry, 2017. "“Look at the Whole Me”: A Mixed-Methods Examination of Black Infant Mortality in the US through Women’s Lived Experiences and Community Context," IJERPH, MDPI, vol. 14(7), pages 1-14, July.
    2. Alea Jones & Ijeoma Nnadi & Kelly Centeno & Giselle Molina & Rida Nasir & Gina G. Granger & Nicholas R. Mercado & Andrea A. Ault-Brutus & Martine Hackett & Ibraheem M. Karaye, 2023. "Investigating the Spatial Relationship between Social Vulnerability and Healthcare Facility Distribution in Nassau County, New York," IJERPH, MDPI, vol. 20(5), pages 1-10, February.

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