The point of the paper is to spur researchers and policymakers to start thinking about social mobility as a social determinant of health, particularly for poor Americans. Key figure here. 2/pic.twitter.com/VDTYNS8plI
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New descriptive paper with @sebadaza and Zeke Emanuel in @JAMAInternalMed examining association between county-level social mobility (a measure of economic opportunity) and life expectancy at age 40: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2759132 … 1/
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We find a strong association between social mobility and life expectancy (net of a few other key county characteristics including income inequality and per capita income) for Americans in the bottom income quartile. 3/
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We are very clear throughout that we cannot prove causality with our research design. But we believe this kind of description is important for a few reasons. 4/
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First, there quite a few specific, quasi-experimental case studies that suggest that prospects for upward mobility - i.e., the American Dream - may causally shape health behaviors and health. I highlight some of this in an earlier thread: https://twitter.com/atheendar/status/1211682615062925312 …. 5/
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Thus, we believe the macro-level association we uncover is worth taking seriously - and invite causal-minded researchers to take a crack. 6/
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Second, even if the association we recover is NOT a causal one, it is still important. I'm thinking specifically of a type of confounding where other variables jointly influence mobility and health. What are those forces? Are they good targets for policy? 7/
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Emerging research suggests they might be. For example, historic medicaid expansions, early childhood investments, reductions in air pollution all have been shown to improve health AND economic outcomes. 8/
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Our discussions (within the confines of how medical journal articles are written) tries to explore this vast policy space. The associated editorial by
@KBibbinsDomingo and@MariaGlymour is TERRIFIC and is exactly how we hope people think about our paper. 9/Prikaži ovu nit -
In the end, I think American's care deeply about their futures and that having hope for the future is critical for health. We've spent 6+ years seeing this over and over in our data, and
@WuDunn +@NickKristof latest book tells this story beautifully. https://www.nytimes.com/2020/01/18/opinion/sunday/deaths-despair-personal-responsibility.html … 10/Prikaži ovu nit -
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