New Horizons in Modeling and Simulation for Social Epidemiology and Public Health. Daniel Kim

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New Horizons in Modeling and Simulation for Social Epidemiology and Public Health - Daniel Kim

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on health inequalities: a review of reviews. The Lancet 390: S12.

      40 WHO and the Government of South Australia (2010). The Adelaide Statement on Health in All Policies: moving towards a shared governance for health and well‐being. Health Promotion International 25 (2): 258–260.

      41 WHO Commission on the Social Determinants of Health (2008). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization.

      42 Woolf, S.H. and Braveman, P. (2011). Where health disparities begin: the role of social and economic determinants – and why current policies may make matters worse. Health Affairs 30 (10): 1852–1859.

      43 World Health Organization (2016a). Rio Political Declaration on Social Determinants of Health, 2011. Brazil: World Health Organization.

      44 World Health Organization (2016b). Global Monitoring of Action on the Social Determinants of Health: a Proposed Framework and Basket of Core Indicators. Geneva: World Health Organization.

       Daniel Kim1,2 and Ross A. Hammond3,4,5

       1 Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA

       2 School of Public Policy and Urban Affairs, Northeastern University, Boston, MA, USA

       3 Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA

       4 Brown School, Washington University in St. Louis, St. Louis, MO, USA

       5 The Santa Fe Institute, Santa Fe, NM, USA

      The real world is made up of a series of complex systems. As we have seen in Chapter 1, health and disease are products of causal factors operating through multiple pathways at multiple levels. Such complex systems are not simply linear—they are characterized by causal feedback loops and complex interactions between actors at multiple levels and are inherently dynamic. Traditional multivariable models adopt a more reductionist approach and lack the ability to capture such features. In general, they implement static or discretely longitudinal analyses, do not incorporate potential nonlinearities such as feedback loops, and do not capture behavioral responses of individuals (Luke and Stamatakis 2012). By contrast, systems science approaches were explicitly developed to account for such features.

      Although variation in the relationship between exposures and outcomes that is “exogenous” or “as if random” is the primary objective of advanced methods used to strengthen causal inference, the real world is filled with endogeneity. Endogenous factors are those found within the same system, meaning that they may bias the association between an exposure and an outcome. Notably, systems science approaches do not regard the endogeneity of the real world as nuisances; rather, through a more holistic approach, they model the presence of such complex pathways and mechanisms to better understand them (Luke and Stamatakis 2012).

      Agent‐Based Modeling

      Microsimulation Models

      Microsimulation models (MSM) enable simulations of policies on samples of economic agents (individual, households, and firms) at the individual level (Bourguignon and Spadaro 2006). These simulations allow for the projection of the consequences of modifying economic conditions for each individual agent in the sample. Through such projections, we can estimate the overall aggregate impacts of a policy as well as the distributional consequences of the policy in terms of “winners” and “losers.” These could be population subgroups as defined by social axes including age, gender, race/ethnicity, and socioeconomic status. Such policies may be expensive and not readily feasible to undertake in the real world. For example, changing the income tax structure can alter what absolute income individuals in a population receive and influence the distribution of income (i.e. levels of income inequality) within the population. Through tax microsimulation, we can hence project the absolute and relative income impacts without actually implementing these changes in the real world. MSM can thus offer a convenient and inexpensive means to estimate the overall population impacts of social policies.

      Other Complex Systems Modeling Tools

      Other key systems science approaches (not reviewed in this book) include

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