Social determinants of health are the conditions in which people are born, grow, live, work, and age, and they play a key role in determining a population's health.
The Social Determinants research team studies the distribution and impact of societal conditions relevant to health. These indicators are descriptors of different societies and are useful as predictors of health outcomes and the uptake of health interventions. IHME researchers are identifying all existing data sources and developing new methods to generate the best metrics to characterize these societal factors. Our goal is to produce the largest and most accurate datasets of social determinants relevant to population health, with results that will be valuable to researchers and policymakers around the world.
- Measure educational attainment and inequalities in education and quantify their impact on health
Education is a major determinant of health. In order to be able to quantify the impact of increased educational attainment on health outcomes, we produced the most comprehensive time series of average years of schooling for all countries between 1970 and 2009. We compiled all publicly available censuses and nationally representative surveys of respondents’ educational attainment, including 915 sources of data from 219 countries between 1953 and 2008.
Overall, there has been substantial progress in the global attainment of education between 1970 and 2009, and rapid progress in educational attainment in women has resulted in significant reductions in the gender gap in education. We also examined the contribution of increased educational attainment on reductions in child mortality and found that about 50% of the reduction in child mortality can be attributed to improvements in levels of education around the world.
To further understand the role of education in child mortality, we are also analyzing all nationally representative Demographic and Health Surveys using a hierarchical logistic regression model. In this individual-level analysis, we control for relevant covariates, including household wealth, and a series of mother- and child-specific variables, which included the mother’s age, the spacing between births, and other factors. The results quantify the reduction in child mortality for every additional year of schooling received by a woman of reproductive age and highlight the importance of focusing policies on women who are currently receiving no education.
- Develop a time series for gross domestic product
We generated the first set of complete time series of gross domestic product (GDP) per capita for all countries from 1950 to 2015 by compiling six data sources and using mixed effects models to generate the GDP per capita series. We produced one series in purchasing power parity/international dollars and another in constant US dollars. In the future, we can expand this time series to estimate urban and rural GDP per capita or other subnational levels of GDP.
- Estimate household wealth and wealth inequality
We are currently developing asset-based wealth indices for use as covariates when analyzing health surveys. Existing indices suffer from the limitation that they can only be used to compare households within one survey at a time. Our method produces an index that is comparable across countries and over time, using information on ownership of assets as well as sociodemographic characteristics of the household. Additionally, we are combining these indices with income and expenditure data collected in household surveys to generate the most comprehensive and robust estimates of household wealth. This information will also be used to measure economic inequality within countries, changes in inequality over time, and relationships between economic inequality and health outcomes.
The Social Determinants research team encourages other researchers around the world to use our work. The research conducted by this team includes many important covariates for all fields of work, and we believe our work will add value to the international research community, increase knowledge about social determinants, and allow for more effective resource allocation to improve population health.
Related Publications & Presentations
Gakidou E, Cowling K, Lozano R, Murray CJL. Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis. The Lancet. 2010; 376:959–974.