{"id":"https://openalex.org/W2127430770","doi":"https://doi.org/10.1377/hlthaff.2011.0685","title":"Where Health Disparities Begin: The Role Of Social And Economic Determinants\u2014And Why Current Policies May Make Matters Worse","display_name":"Where Health Disparities Begin: The Role Of Social And Economic Determinants\u2014And Why Current Policies May Make Matters Worse","publication_year":2011,"publication_date":"2011-10-01","ids":{"openalex":"https://openalex.org/W2127430770","doi":"https://doi.org/10.1377/hlthaff.2011.0685","mag":"2127430770","pmid":"https://pubmed.ncbi.nlm.nih.gov/21976326"},"language":"en","primary_location":{"id":"doi:10.1377/hlthaff.2011.0685","doi":"https://doi.org/10.1377/hlthaff.2011.0685","is_oa":false,"landing_page_url":"https://doi.org/10.1377/hlthaff.2011.0685","pdf_url":null,"source":{"id":"https://openalex.org/S4210185023","display_name":"Health Affairs","issn_l":"0278-2715","issn":["0278-2715","1544-5208","2694-233X"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["anvur-scientific","dongbi-a","doyens","fnege-2","jufo-2","medline","norway-1","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315983","host_organization_name":"Project HOPE","host_organization_lineage":["https://openalex.org/P4310315983"],"host_organization_lineage_names":["Project HOPE"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","datacite","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.13016/wn0x-phqw","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5001758658","display_name":"Steven H. Woolf","orcid":"https://orcid.org/0000-0001-9384-033X","observed_orcids":["https://orcid.org/0000-0001-9384-033X"]},"institutions":[{"id":"https://openalex.org/I184840846","display_name":"Virginia Commonwealth University","ror":"https://ror.org/02nkdxk79","country_code":"US","type":"education","lineage":["https://openalex.org/I184840846"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Steven H. Woolf","raw_affiliation_strings":["Steven H. Woolf ( ) is the director of the Center on Human Needs and a professor in the Department of Family Medicine at Virginia Commonwealth University, in Richmond"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Steven H. Woolf ( ) is the director of the Center on Human Needs and a professor in the Department of Family Medicine at Virginia Commonwealth University, in Richmond","institution_ids":["https://openalex.org/I184840846"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5075828431","display_name":"Paula Braveman","orcid":"https://orcid.org/0000-0001-9917-2360","observed_orcids":["https://orcid.org/0000-0001-9917-2360"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Paula Braveman","raw_affiliation_strings":["Paula Braveman is the director of the Center on Social Disparities in Health at the University of California, San Francisco (UCSF), and a professor of family and community medicine at UCSF"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Paula Braveman is the director of the Center on Social Disparities in Health at the University of California, San Francisco (UCSF), and a professor of family and community medicine at UCSF","institution_ids":["https://openalex.org/I180670191"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":19.3004,"has_fulltext":false,"cited_by_count":410,"citation_normalized_percentile":{"value":0.99675,"is_in_top_1_percent":true,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":99,"max":100},"biblio":{"volume":"30","issue":"10","first_page":"1852","last_page":"1859"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10235","display_name":"Health disparities and outcomes","score":0.9574999809265137,"subfield":{"id":"https://openalex.org/subfields/3306","display_name":"Health"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10235","display_name":"Health disparities and outcomes","score":0.9574999809265137,"subfield":{"id":"https://openalex.org/subfields/3306","display_name":"Health"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13633","display_name":"Public Health and Social Inequalities","score":0.039799999445676804,"subfield":{"id":"https://openalex.org/subfields/3306","display_name":"Health"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12041","display_name":"Public Health Policies and Education","score":0.0010000000474974513,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/health-disparities","display_name":"health disparities","score":0.9990000128746033},{"id":"https://openalex.org/keywords/social-determinants-of-health","display_name":"social determinants of health","score":0.996999979019165},{"id":"https://openalex.org/keywords/economic-determinants-of-health","display_name":"economic determinants of health","score":0.9309999942779541},{"id":"https://openalex.org/keywords/racial-and-ethnic-disparities","display_name":"racial and ethnic disparities","score":0.8579999804496765},{"id":"https://openalex.org/keywords/income-and-education-disparities","display_name":"income and education disparities","score":0.7260000109672546},{"id":"https://openalex.org/keywords/neighborhood-conditions","display_name":"neighborhood conditions","score":0.6269999742507935},{"id":"https://openalex.org/keywords/health-policy","display_name":"health policy","score":0.6320000290870667},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.640999972820282},{"id":"https://openalex.org/keywords/disease-burden","display_name":"disease burden","score":0.6600000262260437},{"id":"https://openalex.org/keywords/housing-policy","display_name":"housing policy","score":0.5630000233650208},{"id":"https://openalex.org/keywords/land-use-and-transportation","display_name":"land use and transportation","score":0.7990000247955322},{"id":"https://openalex.org/keywords/childcare-policy","display_name":"childcare policy","score":0.7039999961853027},{"id":"https://openalex.org/keywords/education-policy","display_name":"education policy","score":0.656000018119812},{"id":"https://openalex.org/keywords/community-revitalization","display_name":"community revitalization","score":0.6669999957084656}],"concepts":[{"id":"https://openalex.org/C2777363581","wikidata":"https://www.wikidata.org/wiki/Q15098235","display_name":"Harm","level":2,"score":0.7109178304672241},{"id":"https://openalex.org/C2250968","wikidata":"https://www.wikidata.org/wiki/Q1512929","display_name":"Health equity","level":3,"score":0.7042177319526672},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.6020035147666931},{"id":"https://openalex.org/C78491826","wikidata":"https://www.wikidata.org/wiki/Q3045352","display_name":"Social determinants of health","level":3,"score":0.5967797040939331},{"id":"https://openalex.org/C137403100","wikidata":"https://www.wikidata.org/wiki/Q41710","display_name":"Ethnic group","level":2,"score":0.5338396430015564},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.46760764718055725},{"id":"https://openalex.org/C100001284","wikidata":"https://www.wikidata.org/wiki/Q2248246","display_name":"Public economics","level":1,"score":0.4438628852367401},{"id":"https://openalex.org/C104977270","wikidata":"https://www.wikidata.org/wiki/Q16000306","display_name":"Race and health","level":4,"score":0.44025281071662903},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.4257957339286804},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.39715155959129333},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.37860292196273804},{"id":"https://openalex.org/C4249254","wikidata":"https://www.wikidata.org/wiki/Q3044431","display_name":"Demographic economics","level":1,"score":0.375702440738678},{"id":"https://openalex.org/C47768531","wikidata":"https://www.wikidata.org/wiki/Q1127188","display_name":"Development economics","level":1,"score":0.36116230487823486},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.35386067628860474},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.307842880487442},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.2983126938343048},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006291","descriptor_name":"Health Policy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006297","descriptor_name":"Health Services Accessibility","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011057","descriptor_name":"Politics","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012931","descriptor_name":"Social Environment","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012959","descriptor_name":"Socioeconomic Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D054525","descriptor_name":"Minority Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D054624","descriptor_name":"Health Status Disparities","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D054625","descriptor_name":"Healthcare Disparities","qualifier_ui":"Q000208","qualifier_name":"ethnology","is_major_topic":true}],"locations_count":5,"locations":[{"id":"doi:10.1377/hlthaff.2011.0685","doi":"https://doi.org/10.1377/hlthaff.2011.0685","is_oa":false,"landing_page_url":"https://doi.org/10.1377/hlthaff.2011.0685","pdf_url":null,"source":{"id":"https://openalex.org/S4210185023","display_name":"Health Affairs","issn_l":"0278-2715","issn":["0278-2715","1544-5208","2694-233X"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":["anvur-scientific","dongbi-a","doyens","fnege-2","jufo-2","medline","norway-1","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315983","host_organization_name":"Project HOPE","host_organization_lineage":["https://openalex.org/P4310315983"],"host_organization_lineage_names":["Project HOPE"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health Affairs","raw_type":"journal-article"},{"id":"pmid:21976326","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/21976326","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Health affairs (Project Hope)","raw_type":"Journal Article"},{"id":"pmh:oai:drum.lib.umd.edu:1903/23899","doi":null,"is_oa":false,"landing_page_url":"http://hdl.handle.net/1903/23899","pdf_url":null,"source":{"id":"https://openalex.org/S4306401518","display_name":"University Libraries (University of Maryland)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I66946132","host_organization_name":"University of Maryland, College Park","host_organization_lineage":["https://openalex.org/I66946132"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Article"},{"id":"doi:10.13016/wn0x-phqw","doi":"https://doi.org/10.13016/wn0x-phqw","is_oa":true,"landing_page_url":"https://doi.org/10.13016/wn0x-phqw","pdf_url":null,"source":{"id":"https://openalex.org/S4306402644","display_name":"Digital Repository at the University of Maryland (University of Maryland College Park)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I66946132","host_organization_name":"University of Maryland, College Park","host_organization_lineage":["https://openalex.org/I66946132"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":null},{"id":"mag:2189489821","doi":null,"is_oa":false,"landing_page_url":"https://content.healthaffairs.org/content/30/10/1852.full.pdf","pdf_url":null,"source":null,"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":null}],"best_oa_location":{"id":"doi:10.13016/wn0x-phqw","doi":"https://doi.org/10.13016/wn0x-phqw","is_oa":true,"landing_page_url":"https://doi.org/10.13016/wn0x-phqw","pdf_url":null,"source":{"id":"https://openalex.org/S4306402644","display_name":"Digital Repository at the University of Maryland (University of Maryland College Park)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I66946132","host_organization_name":"University of Maryland, College Park","host_organization_lineage":["https://openalex.org/I66946132"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":null},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/10","score":1.0,"display_name":"Reduced inequalities"},{"id":"https://metadata.un.org/sdg/3","score":0.8199999928474426,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":29,"referenced_works":["https://openalex.org/W1565299646","https://openalex.org/W1602507397","https://openalex.org/W1627232924","https://openalex.org/W1686749590","https://openalex.org/W1918881530","https://openalex.org/W1979953427","https://openalex.org/W1988443095","https://openalex.org/W2001238160","https://openalex.org/W2004715991","https://openalex.org/W2008266470","https://openalex.org/W2010069622","https://openalex.org/W2021018230","https://openalex.org/W2024517143","https://openalex.org/W2051454095","https://openalex.org/W2069393458","https://openalex.org/W2091424052","https://openalex.org/W2097275837","https://openalex.org/W2098621992","https://openalex.org/W2101374995","https://openalex.org/W2104291181","https://openalex.org/W2109933771","https://openalex.org/W2116769437","https://openalex.org/W2119683858","https://openalex.org/W2138696311","https://openalex.org/W2146488570","https://openalex.org/W2148081515","https://openalex.org/W2164184454","https://openalex.org/W2409419962","https://openalex.org/W4245198606"],"related_works":["https://openalex.org/W2189489821","https://openalex.org/W4321485958","https://openalex.org/W2755089705","https://openalex.org/W2087627141","https://openalex.org/W1935752371","https://openalex.org/W7047457102","https://openalex.org/W2048194622","https://openalex.org/W4414552220","https://openalex.org/W2162049040","https://openalex.org/W2334518142"],"abstract_inverted_index":{"Health":[0],"disparities":[1,17,47],"by":[2,8,16,98],"racial":[3],"or":[4,7,10],"ethnic":[5],"group":[6],"income":[9,28],"education":[11,22],"are":[12],"only":[13],"partly":[14],"explained":[15],"in":[18,44,90],"medical":[19,81,96],"care.":[20],"Inadequate":[21],"and":[23,35,62,67,75,80,102],"living":[24],"conditions-ranging":[25],"from":[26],"low":[27],"to":[29],"the":[30],"unhealthy":[31],"characteristics":[32],"of":[33],"neighborhoods":[34],"communities-can":[36],"harm":[37],"health":[38,46,79,104],"through":[39],"complex":[40],"pathways.":[41],"Meaningful":[42],"progress":[43],"narrowing":[45],"is":[48],"unlikely":[49],"without":[50],"addressing":[51],"these":[52,72,91],"root":[53,73],"causes.":[54],"Policies":[55],"on":[56,71,87],"education,":[57],"child":[58],"care,":[59],"jobs,":[60],"community":[61],"economic":[63],"revitalization,":[64],"housing,":[65],"transportation,":[66],"land":[68],"use":[69],"bear":[70],"causes":[74],"have":[76],"implications":[77],"for":[78],"spending.":[82],"A":[83],"shortsighted":[84],"political":[85],"focus":[86],"reducing":[88],"spending":[89],"areas":[92],"could":[93],"actually":[94],"increase":[95],"costs":[97],"magnifying":[99],"disease":[100],"burden":[101],"widening":[103],"disparities.":[105]},"counts_by_year":[{"year":2026,"cited_by_count":9},{"year":2025,"cited_by_count":14},{"year":2024,"cited_by_count":31},{"year":2023,"cited_by_count":33},{"year":2022,"cited_by_count":28},{"year":2021,"cited_by_count":43},{"year":2020,"cited_by_count":33},{"year":2019,"cited_by_count":39},{"year":2018,"cited_by_count":35},{"year":2017,"cited_by_count":28},{"year":2016,"cited_by_count":37},{"year":2015,"cited_by_count":19},{"year":2014,"cited_by_count":25},{"year":2013,"cited_by_count":21},{"year":2012,"cited_by_count":13}],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2016-06-24T00:00:00"}
