Thursday, September 01, 2022

WORKPLACE SOCIAL RELATIONS

First impressions formed during “small talk” may influence future strategic interactions

Study participants co-operated more with partners they believed to be extroverts in strategic games

Peer-Reviewed Publication

PLOS

Two people having a conversation. 

IMAGE: TWO PEOPLE HAVING A CONVERSATION. view more 

CREDIT: PRISCILLA DU PREEZ, UNSPLASH, CC0 (HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

In a new study, participants who engaged in small talk with others formed impressions about their conversation partners’ personalities that subsequently appeared to influence their behavior when playing strategic games with them. Neha Bose and Daniel Sgroi of the University of Warwick, U.K., present these findings in the open-access journal PLOS ONE on August 31, 2022.

Numerous prior studies have examined the role of people’s personalities on strategic behavior in the field of economics. However, less is known about how people’s impressions of others’ personalities might influence strategic interactions. Previous research has explored how personality impressions may arise through face-to-face interactions, observing others’ physical appearance, or observing their behavior.

To expand understanding of personality impressions and strategic behavior, Bose and Sgroi conducted a study focused on impressions formed through “small talk.” Specifically, they asked 168 participants to engage in 4 minutes of instant-messaging-based conversation with another participant. Next, participants noted their impressions of their conversation partners’ personality, with a focus on extraversion and neuroticism. Finally, participants were asked to engage their conversation partner in two strategic games. For comparison, 170 additional participants did not engage in small talk before playing the games.

The researchers found that participants who engaged in small talk formed impressions about their partners’ personalities—particularly regarding their level of extraversion, and these impressions appeared to influence their strategic behavior during the games.

The influence of small-talk-derived personality impressions varied depending on the specific game. In one game with both competitive and cooperative elements, participants behaved more cooperatively if they believed their partner to be extraverted. In a competitive game involving prediction of the opponent’s behavior, participants faced greater difficulty in out-guessing opponents if they felt they shared similar personality traits with each other.

The authors note that this study is exploratory, and that it could serve as a first step towards future research into the links between personality impressions and strategic decision making across a range of real-world contexts.

The authors add: “Our work highlights the importance of regular “small talk” communication, even when it doesn’t seem relevant or important. Through short seemingly trivial interactions with others we become better able to predict the personalities of those we talk with which in turn boosts our performance when we interact with them in the future.”

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In your coverage please use this URL to provide access to the freely available article in PLOS ONEhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269523

Citation: Bose N, Sgroi D (2022) The role of personality beliefs and “small talk” in strategic behaviour. PLoS ONE 17(8): e0269523. https://doi.org/10.1371/journal.pone.0269523

Author Countries: UK, Germany

Funding: Funding for this project was provided by the ESRC CAGE Centre (Grant Ref RES-626-28-0001). University of Warwick Departmental IRB approval obtained (12-03-2018). The experiment for the study is registered at the AEA RCT Registry (RCT ID AEARCTR-0002903) https://www.socialscienceregistry.org/trials/2903. The authors are grateful to Thomas Hills, Kirill Pogorelskiy, Anu Realo, Gordon Brown and Sharun Mukand from Warwick University for helpful discussions related to the paper and to John Taylor from Warwick Business School for help with the experimental sessions. The authors would also like to thank Andis Sofianos for providing the Raven’s test matrices used in Proto, Rustichini, and Sofianos, 2019. Relevant data and code is available via GitHub at https://github.com/boseneha/Personality-beliefs-andsmall-talk.

How can a welfare state boost population health?

Researchers analyzing 21 countries from 1971 to 2010 found an association between decommodification and a lower age-standardized death rate.

Peer-Reviewed Publication

PLOS

“Social Security” written on a typewriter. 

IMAGE: “SOCIAL SECURITY” WRITTEN ON A TYPEWRITER. view more 

CREDIT: MARKUS WINKLER, PEXELS, CC0 (HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

Welfare state decommodification is associated with a lower age-standardized death rate and improved population health due to both direct and indirect mechanisms, according to a new study published this week in the open-access journal PLOS ONE by Olivier Jacques and Alain Noël of the University of Montreal, Canada.

Decommodification—the reduction in the scope and influence of the free market on citizen’s lives—is an outcome of welfare states that provide strong social programs. Previous research has established a relationship between overall welfare state generosity and population health, but the exact mechanisms associating decommodification with health are poorly understood. 

In the new study, the researchers used data spanning 1971 to 2010 on the age-standardized death rate per 100,000 inhabitants in 21 countries belonging to the Organization for Economic Cooperation and Development (OECD). They found a negative correlation between the death rate and levels of decommodification. When they analyzed separate correlates of decommodification, they found that decreased labor market polarization—the ratio of jobs with lower and higher skill and pay— and decreased labor market risk, which describes the risk associated with unemployment, were associated with improved population health, particularly in men. However, income redistribution was not associated with health.

The authors conclude that population health relates less to the direct redistribution of income and more to the reduced vulnerability to risks and social insecurity associated with welfare state generosity.

The authors add: “The welfare state contributes to healthier lives, directly by providing resources and services to individuals, and indirectly by reducing labor market income polarization and risks.”

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In your coverage please use this URL to provide access to the freely available article in PLOS ONEhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0272698

Citation: Jacques O, Noël A (2022) Welfare state decommodification and population health. PLoS ONE 17(8): e0272698. https://doi.org/10.1371/journal.pone.0272698

Author Countries: Canada

Funding: Research contract with the Ministère de la Santé et des Services Sociaux du Québec. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Going with the flow: Study shows the blend of blue and green space at former industrial canals helps boost your mood

Peer-Reviewed Publication

PLOS

Birmingham Main Line Canal 

IMAGE: BIRMINGHAM MAIN LINE CANAL. view more 

CREDIT: CANAL AND RIVER TRUST, CC-BY 4.0 (HTTPS://CREATIVECOMMONS.ORG/LICENSES/BY/4.0/)

Going with the flow: study shows the blend of blue and green space at former industrial canals helps boost your mood

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Article URL:  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0271306

Article Title: The mental health benefits of visiting canals and rivers: An ecological momentary assessment study

Author Countries: UK

Funding: This study was supported by a grant from The Medical Research Council (MRC; https://www.ukri.org/councils/mrc/) (grant number MR/S026428/1) awarded to AM and ST. This study was also supported by a the The National Institute for Health and Care Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London (https://www.maudsleybrc.nihr.ac.uk) awarded to AM. Finally, the study was also supported by The Canal & River Trust (CRT; https://canalrivertrust.org.uk/) awarded to JG and ND. Jenny Shepherd (CRT) and Graham Reeves (CRT) provided feedback on the study design and preparation of the manuscript. No other funders had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Racehorses perform just as well with female jockeys as males in training and races, per analysis of Australian race yard

Peer-Reviewed Publication

PLOS

Racehorses training with Equimetre data-logging device. 

IMAGE: RACEHORSES TRAINING WITH EQUIMETRE DATA-LOGGING DEVICE. view more 

CREDIT: ARIONEO LTD, CC-BY 4.0 (HTTPS://CREATIVECOMMONS.ORG/LICENSES/BY/4.0/)

Racehorses perform just as well with female jockeys as males in training and races, per analysis of Australian race yard

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Article URL:  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0273310

Article Title: Does sex of the jockey influence racehorse physiology and performance

Author Countries: UK, France, Belgium

Funding: The authors received no specific funding for this work. Arioneo Ltd provided all data used in this study but had no role in study design or analysis, decision to publish, or preparation of the manuscript.



Old drugs hint at new ways to beat chronic pain

A newly identified link between chronic pain and lung cancer in mice offers hope for pain management

Peer-Reviewed Publication

IMBA- INSTITUTE OF MOLECULAR BIOTECHNOLOGY OF THE AUSTRIAN ACADEMY OF SCIENCES

Visualizing pain in mouse sensory neurons (I) 

IMAGE: MOUSE SENSORY NEURONS ARE SHOWN IN MAGENTA. BH4, THE MOLECULE DRIVING CHRONIC PAIN, IS SHOWN IN GREEN. HENCE, THE NEURONS “IN PAIN” ARE SEEN IN GREEN/WHITE. view more 

CREDIT: ©CRONIN/IMBA

Pain is an important alarm system that alerts us to tissue damage and prompts us to withdraw from harmful situations. Pain is expected to subside as injuries heal, but many patients experience persistent pain long after recovery. Now, a new study published in Science Translational Medicine points to possible new treatments for chronic pain with a surprising link to lung cancer. The work was spearheaded by an international team of researchers at IMBA – Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Harvard Medical School, and Boston Children’s Hospital. Their findings of the research, conducted in laboratory mouse models, open up multiple therapeutic opportunities that could allow the world to improve chronic pain management and eclipse the opioid epidemic.

 

Acute pain is an important danger signal. By contrast, chronic pain is based on persistent injury and can even be experienced in the absence of a stimulus, injury, or disease. Despite the hundreds of millions of people affected, chronic pain is among the least well-managed areas of healthcare. To improve how persistent pain is managed and considering the raging opioid crisis, it is paramount to develop novel drugs based on a fundamental understanding of the underlying mechanisms. “We had previously shown that sensory neurons produce a specific metabolite, BH4, which then drives chronic pain, such as neuropathic pain or inflammatory pain,” says project lead and co-corresponding author Shane Cronin, a staff scientist in the Penninger lab at IMBA and a former postdoc in the Woolf lab at Harvard Medical School and F.M. Kirby Neurobiology Center, Boston Children’s Hospital. “The concentrations of BH4 correlated very well with the pain intensity. So, we naturally thought that this was a great pathway to target.

To identify drugs that reduce BH4 levels in pain neurons, the researchers performed a “phenotypic screen” of 1000 target-annotated, FDA-approved medications. This approach allowed the scientists to start their search using medications that are currently in use for various indications, and to identify undescribed, off-target analgesic properties. Among the first findings of this hypothesis-driven search, the team was able to link the previously observed analgesic effects of several drugs, including clonidine and capsaicin, to the BH4 pathway.

However, our phenotypic screen also allowed us to ‘repurpose’ a surprising drug,” says Cronin. The drug ‘fluphenazine’, an antipsychotic, has been used to treat schizophrenia. “We found that fluphenazine blocks the BH4 pathway in injured nerves. We also demonstrated its effects in chronic pain following nerve injury in vivo.” The researchers also found that the effective analgesic dose of fluphenazine in their experiments in the mouse model is comparable to the low end of the doses safely indicated for schizophrenia in humans.

In addition, the screen uncovered a novel and unexpected molecular link between the BH4 pathway and EGFR/KRAS signaling, a pathway involved in multiple cancers. Blocking EGFR/KRAS signaling reduced pain sensitivity by decreasing the levels of BH4. The genes of EGFR and KRAS are the two most frequently mutated genes in lung cancer, which prompted the researchers to look at BH4 in lung cancer. Surprisingly, by deleting an important enzyme, GCH1, in the BH4 pathway, the mouse models of KRAS-driven lung cancer developed fewer tumors and survived much longer. Hence, the researchers uncovered a common signaling pathway for chronic pain and lung cancer through EGFR/KRAS and BH4, thus opening up new avenues of treatment for both conditions.

Chronic pain is currently subjected to often ineffective palliative treatments. Furthermore, effective painkillers such as opioids can lead, if used inappropriately, to severe addiction. It is therefore critical to find and develop new and repurposed drugs to treat chronic pain,” says co-corresponding author Clifford Woolf, professor of neurology and neurobiology at Harvard Medical School and director of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital.

One intriguing aspect of the study is the mechanistic link between pain and lung cancer. “The same triggers that drive tumor growth appear to be also involved in setting the path to chronic pain, often experienced by cancer patients. We also know that sensory nerves can drive cancer, which could explain the vicious circuit of cancer and pain,” adds co-corresponding author Josef Penninger, IMBA group leader and founding director, who is currently also the director of the Life Sciences Institute at the University of British Columbia (UBC), Vancouver, Canada. “Understanding these cross-talks is therefore not only critical for cancer treatments but might also help to improve the quality of life for cancer patients towards less pain.

Mouse sensory neurons are shown in green. BH4, the molecule driving chronic pain, is shown in magenta. Hence, the neurons “in pain” are seen in magenta/white.

CREDIT

©Cronin/IMBA

Original publication:

Cronin, S. J. F., et al., “Phenotypic drug screen uncovers the metabolic GCH1/BH4 pathway as key regulator of EGFR/KRAS-mediated neuropathic pain and lung cancer”. Science Translational Medicine, 2022. DOI: 10.1126/scitranslmed.abj1531

 

About IMBA:

IMBA – Institute of Molecular Biotechnology – is one of Europe's leading biomedical research institutes. IMBA is located at the Vienna BioCenter, the vibrant cluster of universities, research institutes, and biotech companies in Austria. IMBA is a subsidiary of the Austrian Academy of Sciences, the leading national sponsor of non-university academic research. The stem cell and organoid research at IMBA are being funded by the Austrian Federal Ministry of Science and the City of Vienna.

More than half of hospital-based maternal deaths occur at times other than childbirth

Study suggests hospital-based maternal deaths are occurring earlier in pregnancy or postpartum – while maternal deaths occurring at the time of delivery are declining in the U.S.

Peer-Reviewed Publication

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

Hospitalizations that occur in the antenatal period – or during pregnancy, but before giving birth— and those that occur in the postpartum period, made up over half of in-hospital maternal deaths between 2017-2019, a new study reveals.

The findings, published in JAMA Network Open, estimated rates of in-hospital maternal deaths from the National Inpatient Sample from the years 1994 to 2015 and from 2017 to 2019 among antenatal, childbirth, and postpartum hospitalizations in the United States. 

“Maternal mortality rates are high in the United States, higher than as seen in all other industrialized countries”, said lead author Lindsay Admon, M.D., MSc, an assistant professor of obstetrics and gynecology at the University of Michigan Medical School and obstetrician-gynecologist at University of Michigan Von Voigtlander Women’s Hospital.

“Maternal mortality continues to increase in the U.S, and we wanted to understand trends in hospital-based deaths: Are they happening during pregnancy, at birth, or postpartum? Has this changed over time? Basically, we wanted to generate data that could help design clinical and policy interventions for preventing the most adverse of all obstetric outcomes in the hospital setting, maternal death.

In their recent study, Admon and co-authors found that over the 20-year period between 1994- 1995 and 2014-2015, in-hospital maternal deaths occurring at the time of childbirth declined by more than half (56%). During the same period, rates of in-hospital maternal death occurring during the antenatal and postpartum periods remained unchanged.

In looking at the most recent data from 2017 to 2019, the research team found that hospitalizations for childbirth accounted for nearly 90% of hospitalizations occurring during pregnancy through a few weeks after childbirth – but for only half of in-hospital maternal deaths. 

In contrast, antenatal and postpartum hospitalizations accounted for less than 10% of all hospitalizations occurring during pregnancy through a few weeks after childbirth, but half of the in-hospital maternal deaths identified.

“It’s important to note that it appears progress has been made in lowering the rate of maternal death at the time of childbirth,” said Admon. “At the same time, we know that maternal mortality continues to increase in the U.S. To further lower rates of maternal death occurring in the hospital, we need to focus not only on the time of delivery but also examine risks and complications occurring during antenatal and postpartum hospitalizations as well.”

Perinatal Quality Collaboratives and resources such as patient safety bundles provided by The Alliance for Innovation on Maternal Health have been implemented in hospitals across the U.S. to reduce preventable maternal mortality, and research has shown that in many cases this has improved rates of maternal morbidity and mortality at the time of childbirth.

With this new study, Admon says there needs to be a renewed focus on examining the causes of in-hospital maternal death during pregnancy periods other than delivery.

“We’re ready to dig into this work further and determine the main drivers of maternal deaths occurring during antenatal and postpartum hospitalizations and whether these differ from those influencing delivery-related outcomes,” she explained.

“Detailed reviews of each case are so important. Once the root causes are identified, clinical and policy changes can be more clearly directed towards improving maternal health and reducing maternal morbidity and mortality.”

Study cited: “Trends and Distribution of In-Hospital Mortality Among Pregnant and Postpartum Individuals by Pregnancy Period,” DOI: 10.1001/jamanetworkopen.2022.24614

American River Basin Study finds that increasing temperatures and changing precipitation will impact basin through rest of 21st century

The study highlights a changing climate's impact to water resources and recommends evaluating adaptation strategies to address these vulnerabilities to the water supply

Reports and Proceedings

BUREAU OF RECLAMATION

American River 

IMAGE: THE LOWER AMERICAN RIVER NEAR SACRAMENTO CALIFORNIA. view more 

CREDIT: BUREAU OF RECLAMATION

WASHINGTON – The American River Basin in central California expects to see increasing temperatures and a declining snowpack through the end of the 21st century. The Bureau of Reclamation released the American River Basin Study today, which also found an increased variability of fall and winter precipitation that will amplify the severity of droughts and flooding in the basin. The report is available on Reclamation's Basin Study website.  

"Water management in the basin is expected to be more challenging in the future due to climate pressures that include warming temperatures, shrinking snowpack, shorter and more intense wet seasons and rising sea levels," said California-Great Basin Regional Director Ernest Conant. "We are excited for the partnerships and collaboration within the basin and look forward to working with them on the identified adaptation portfolios to address the vulnerabilities and maintain a balance between supply and demand in the basin."

The American River Basin Study found that maximum temperatures are projected to increase throughout the year, with the most significant increase of 7.3°F during the summer months by the end of the 21st century. While projections of average annual precipitation are uncertain, climate projections indicate a change in precipitation timing and variability. Precipitation is projected to be increasingly variable into the future with the timing of the moisture shifting with fall and spring precipitation declining and winter and summer precipitation increasing. In addition, the snowpack will decrease due to warming, moving the peak runoff by more than a month by the mid to late century.

Adaptation strategies are already underway in the basin to increase agricultural and urban water use efficiency, water transfers and exchanges within the basin and improving headwaters and forest health.  New adaptation strategy portfolios were also developed for further evaluation by Reclamation and the collaborators to maintain a balance between supply and demand. For example, one adaptation portfolio highlights the importance of long-term Central Valley Project contracts for regional reliability. Other adaptation portfolios included evaluating:

  • The use of high elevation, off-stream storage to replace lost storage from reduced snowpack and earlier snowmelt.
  • The use of existing diversion facilities on the Sacramento River and exchange water supply to reduce reliance on Folsom Reservoir and the American River.
  • The raise of Folsom Dam other upstream flood control space through facility modifications to increase flood control space.
  • Releasing flood water earlier to recharge groundwater creates additional regional water supply and ecosystem benefits.
  • The effectiveness of the flow management standard for the Lower American River in the 2015 update of the Sacramento Water Forum Agreement to reduce the effects on the river's ecosystem and fisheries from climate change.

The basin study was selected in 2017 and built upon the Sacramento and San Joaquin Rivers Basin Study completed in 2016. The American River Basin and the area covered by this study consists of 3,600 square miles in central California from the valley through the foothills to the top of the Sierra Nevada. It includes the City of Sacramento and the surrounding area, including Auburn, Citrus Heights, Elk Grove, Folsom, Placerville, Rancho Cordova, Roseville and Shingle Springs.

Reclamation developed the basin study in collaboration with the Placer County Water Agency, City of Roseville, City of Sacramento, El Dorado County Water Agency, City of Folsom, and Regional Water Authority. The non-federal partners also coordinated with the Sacramento Area Flood Control Agency to address the flood risks. Key contributors to the report included the California Department of Water Resources, University of California-Davis, The Water Forum, Sacramento Municipal Utility District and El Dorado Irrigation District.

For more than 100 years, Reclamation and its partners have developed sustainable water and power solutions for the West. This funding is part of the Department of the Interior's WaterSMART Program, which focuses on collaborative efforts to plan and implement actions to increase water supply sustainability, including investments to modernize infrastructure.

To find out more information about the Basin Study Program, please visit Reclamation's WaterSMART program webpage.

Why do galaxies stop making stars? A huge collision in space provides new clues

Merging galaxies may hurl away the gas that fuels new stars, according to a discovery by Pitt astronomers and their colleagues.

Peer-Reviewed Publication

UNIVERSITY OF PITTSBURGH

Six billion years ago, two galaxies were colliding, their combined forces hurling a stream of gas hundreds of thousands of light years away. Reported this week by a team including Pitt astronomers, that unusual feature provides a new possible explanation for why galaxies stop forming stars.

“One of the biggest questions in astronomy is why the biggest galaxies are dead,” said David Setton, a sixth-year physics and astronomy Ph.D. student in the Kenneth P. Dietrich School of Arts and Sciences. “What we saw is that if you take two galaxies and smash them together, that can actually rip gas out of the galaxy itself.”

In the part of space we inhabit, most large galaxies have long ago stopped making new stars. Only recently have astronomers started looking further away — and thus farther back in time — with the tools to find recently dead galaxies and figure out how they got that way.

The cold gas that coalesces to form stars may escape from galaxies by several means, blown away by black holes or supernovae. And there’s an even simpler possibility, that galaxies simply quiet down when they’ve used up all the raw materials for creating stars.

Looking for examples of galaxies that recently shut off star formation, the team of researchers used the Sloan Digital Sky Survey, which has catalogued millions of galaxies with a telescope at Apache Point Observatory in New Mexico. Along with observations from the ground-based radio astronomy network ALMA, the researchers found such a “post-starburst” galaxy seven billion light years away that still showed signs of available star-forming fuel. “So then we needed an explanation,” said Setton. “If it has gas, why is it not forming stars?”

A second pass with the Hubble Space Telescope then revealed the distinctive “tail” of gas extending from the galaxy. From that feature, like forensic examiners working through a telescope, the researchers were able to reconstruct the galaxies’ collision and the tremendous gravitational force that tore apart stars and flung a stream of gas a distance more than two Milky Ways laid end-to-end.

“That was the smoking gun,” said Setton. “We were all so struck by it. You just don’t see this much gas this far away from the galaxy.”

The team, including Pitt Physics and Astronomy Associate Professor Rachel Bezanson and alum Margaret Verrico (A&S ’21) along with colleagues at Texas A&M University and several other institutions, reported their results in the Astrophysical Journal Letters on Aug. 30.

Such an extreme meeting of galaxies is likely rare, Setton said, but because gravity pulls large objects into dense groups, such an event is more common than you might anticipate. “There are all these big voids in space, but all of the biggest galaxies live in the spaces where all of the other big galaxies live,” he said. “You expect to see these sorts of big collisions once every 10 billion years or so for a system this massive.”

Setton’s role on the project was to determine the galaxy’s size and shape, and he discovered that other than the tail, the post-merger galaxy looked surprisingly normal. Once the tail fades in a few hundred million years, it may look just like any other dead galaxy — further suggesting that the process may be more common than it appears, something the team is following up now with another survey.

Along with providing clues for how the universe became the way it is, Setton said such collisions reflects one possibility for the future of our own galaxy.

“If you go do a dark place and look up at the night sky, you can see the Andromeda Galaxy, which in five billion years might do exactly this to our Milky Way,” Setton said. “It’s helping answer the fundamental question of what’s going to happen to the Milky Way in the future.”

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How health systems can help build black wealth

New commentary outlines several strategies, including helping people connect to key services

Peer-Reviewed Publication

UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE

PHILADELPHIA— Health systems can play important roles in helping Black communities build wealth, according to Penn Medicine and Children’s Hospital of Philadelphia (CHOP) experts in a commentary published today in the New England Journal of Medicine.

“Health systems have a choice to make: continue with the status quo or reposition themselves as essential actors in closing the racial wealth gap,” said Eugenia South, MD, the paper’s first author, an assistant professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania and faculty director of Penn Medicine’s Urban Health Lab. “Large, sustained, societal investments are the only way to address the gap, and health systems have a moral obligation to join the movement.”

South and co-authors George Dalembert MD, MSHP, a pediatrician in CHOP’s Care Network and Medical Director of CHOP’s Medical Financial Partnership, and Atheendar Venkataramani, MD, PhD, an assistant professor of Medical Ethics & Health Policy and director of the Opportunity for Health Lab at Penn Medicine, cited data showing that Black Americans comprise about 13 percent of the U.S. population but hold only about 3 percent of the country’s wealth. Moreover, in 2019, the median net worth of white American families was $188,200—several times greater than the $24,100 median net worth of Black American families. Structural racism embedded in both historical and present-day policies and practices both contribute to the racial wealth gap.

While no single institution can solve the problem alone, the authors suggest that health systems are uniquely positioned in several ways to help Black patients, staff members, and neighborhoods in building wealth, a term which generally includes job income, savings, investments, and similar assets or revenue.

“Health systems are well positioned to directly promote wealth building among Black staff, patients, and communities,” South said. “For example, the health care sector is the largest U.S. employer and the largest employer of Black Americans, but Black staff members are often among the lowest-paid employees and have the worst health outcomes. In addition, health systems help to drive their local economies, with both job opportunities and purchasing power.”

The authors recommended several strategies health care systems can utilize. Those steps include:

  • Reducing expenses: Health systems could help patients learn about and enroll in public benefits programs that can cover basic needs. Many low-income households may be eligible for dozens of local, state, and federal benefit programs, such as the Low-Income Home Energy Assistance Program and the Pharmaceutical Assistance Contract for the Elderly. These types of programs allow families to save and begin building wealth.
  • Maximizing income: According to the commentary authors, the health care sector can make a major difference by paying all employees a living wage. In addition, free tax-preparation services can help patients and employees maximize take-home pay.
  • Decreasing debt and increasing savings: Organizations could provide tailored financial counseling, as well as increase assets for Black staff members by connecting them to long-term investment products. One example is Children’s Development Accounts, also known as CDAs or “baby bonds,” special accounts that allow families to save and invest for their children starting at birth. Health systems can also partner with existing local Black-owned small businesses to build capacity and revenue.
  • Reaching Black individuals and communities: Health systems could build pathways for “frictionless” access to wealth-building products and services for patients and employees . One way to facilitate the process, the authors suggest, would be for employees to receive time during normal working hours to participate in wealth-building activities.

The authors also point to the fact that building wealth also has an important benefit of interest to any patient or health care provider: Wealth improves health. They cited a study finding that, among people 54-64 years of age, those in the lowest wealth quintile had a 17 percent risk of death and a 48 percent risk of disability over 10 years. However, people in the top wealth quintile had a 5 percent and 15 percent risk, respectively, in the same categories.

“Wealth is foundational to health,” Venkataramani said. “Wealth affords choice and stability in housing, education, and nutrition, all of which are well-studied social determinants of health. Wealth also provides a cushion for dealing with unexpected emergencies and the weathering effects of chronic stressors. Greater wealth has been associated with reduced premature mortality, lower rates of chronic diseases such as hypertension, and improved functional status throughout life.”

“Health systems do not have to go this road alone – for example, at CHOP, we have laid a groundwork for implementing these strategies using an assets-based approach to this work through cross-sector financial partnerships that recognize the strengths, resources, and resilience of the community we serve,” Dalembert said. “Bottom line – there is a lot health systems can do and, in this piece, we provide health systems with a roadmap to begin to address the racial wealth gap.”

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $9.9 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $546 million awarded in the 2021 fiscal year.

The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 52,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2021, Penn Medicine provided more than $619 million to benefit our community.

About Children’s Hospital of Philadelphia: A non-profit, charitable organization, Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, the 595-bed hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. The institution has a well-established history of providing advanced pediatric care close to home through its CHOP Care Network, which includes more than 50 primary care practices, specialty care and surgical centers, urgent care centers, and community hospital alliances throughout Pennsylvania and New Jersey, as well as a new inpatient hospital with a dedicated pediatric emergency department in King of Prussia. In addition, its unique family-centered care and public service programs have brought Children’s Hospital of Philadelphia recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu