Health commission pushes use of data in health decision making

Greater political will, technical capacity, and community engagement are the keys to ensuring policymakers make the best decisions encompassing all aspects of health, according to an expert report released Tuesday.

The 25-member 3-D Commission — the three Ds are data, social determinants of health, and decision-making — argues that a lack of leadership, prioritization, and investment is to blame for the slow uptake of data-driven actions that consider all factors in people’s health, including environmental, commercial, and cultural elements.

Backed by the Rockefeller Foundation and overseen by the Boston University School of Public Health, the group of commissioners included public health academics and advocates, as well as representatives from Facebook and Microsoft. Their report defines the social determinants of health as “all forces outside the body that affect health.”

The topic has been studied before, including by a 2008 World Health Organization commission. However, Sandro Galea, dean at the Boston University School of Public Health and chair of the 3-D Commission, told Devex that the added value of the new work was to consider how varying factors in health can be measured.

For instance, 1 of 6 principles formulated by the group is that “All available data resources on the determinants of health should be used to inform decision-making about health.” At the same time, Galea pointed to the group’s insistence on transparency and accountability in how people’s data are used.

“We are leagues away from thinking through the issues around data ownership and making sure that the people who are being assessed and measured with data actually have a say in the data that is collected about them and how those data are used,” Galea said.

Galea noted that some “data giants” such as Microsoft and Facebook were “willing to be part of the process” of the commission, though “now in terms of where the process leads and whether or not there is a set of prescriptions that emerge from it and where that takes us is an open question.”

When the group was announced last year, Naveen Rao, senior vice president for health at the Rockefeller Foundation, told Devex that he hoped the report would provide “an action plan, a roadmap” for decision-makers, with a “crisp set of actionable items.”

But Galea said that after much discussion the commissioners decided it was reasonable to focus on overarching principles for policymakers instead.

That was based partly on a “realistic recognition of where the world is,” Galea said, arguing that it remains poorly understood by those in authority that housing and transportation and taxation affect health, for example.

“So [the report] is pushing us there, while we thought that any more concrete roadmaps would actually be unrealistic at this point in time.”