Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.

摘要

OBJECTIVES: To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. METHODS: We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. RESULTS: Given a budget valued at approximately twice an estimated cost of medical and dental care (Dollars 885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. CONCLUSIONS: Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.