The COVID-19 wake-up call: Time to align social determinants and data science to drive decisions and actions to improve health across Europe

Authors: Heidi Larson and Mark Pearson*

One of the most critical issues in global health today is public acceptance of vaccines to fight infectious disease. As countries continue with their COVID-19 vaccination campaigns, pervasive vaccine hesitancy threatens to undermine efforts to recover from the worst public health crisis in many generations. The reasons behind a person’s reluctance are often complicated and nuanced. To uncover and fully understand those reasons requires looking at the issue through a broader lens, one that considers and accounts for a range of factors – socio-economic, political, emotional, and historical. These include non-medical factors such as trust in health systems, education, employment and housing and other factors shaping the conditions of daily life and affecting personal and community dignity. All of these factors influence individual health decisions, health-seeking behavior, quality-of-life risks and outcomes – not just in relation to vaccines, but in many other ways.

“There is no better opportunity than now. We need to deepen our understanding of the determinants of low vaccine uptake, for instance, to inform appropriate interventions to improve uptake. To do that, we need alignment and integration across all three domains: social determinants, big data, and decision-making.”

Our understanding of just how and to what degree these factors affect health has progressed substantially in recent decades. At the same time, we’ve seen huge leaps in how data, including health data, are collected, analyzed, and used to inform action in the health sector.

A recently published report by the Commission on Health Determinants, Data and Decision-making (3-D Commission), an initiative by the Rockefeller Foundation and Boston University School of Public Health, delves into the key drivers that influence health outcomes and illustrates how data science and the social determinants of health can be better integrated into decision-making processes. The findings of the 3-D Commission’s final report are centered around the need to consider the full spectrum of factors, barriers and opportunities for using data on determinants more systematically to inform policies and practices aimed at improving health.

There is no better opportunity than now. We need to deepen our understanding of the determinants of low vaccine uptake, for instance, to inform appropriate interventions to improve uptake. To do that, we need alignment and integration across all three domains: social determinants, big data, and decision-making. The Commission’s report provides a useful roadmap for scholars, practitioners and policymakers alike, with recommendations focused on six core principles for action in three key areas — political will, technical capacity and community engagement – to drive results and improve population health outcomes.

Six principles for action for harnessing determinants, data science and decision-making

1. Evidence-informed decision-making to promote healthy societies needs to go beyond healthcare and incorporate data on the broader determinants of health.

2. All decisions about investments in any sector need to be made with health as a consideration.

3. Decision-making that affects population health needs to embrace health equity — while also acknowledging potential tradeoffs between short- and long-term costs and benefits.

4. All available data resources on the determinants of health should be used to inform decision-making about health.

5. Data on the social determinants of health should contribute to better, more transparent and more accountable governance.

6. Evidence-informed decision-making to promote healthy societies needs to be participatory and inclusive of multiple and diverse perspectives.

We must integrate insights from different types of data with real-life experiences. This will require community participation in data collection and interpretation.  What does the data mean in real life? Trust in the process of data collection and decision-making will come when publics feel that the processes are fair and equitable, and when their reality is acknowledged. As COVID-19 vaccination programs continue across the EU, we must keep working to build trust and taking into account the perspectives and sentiments of groups where confidence in vaccines remains low. By adopting the 3-D approach and leveraging determinants and data science to strengthen decision-making, we will be better prepared and better equipped to effectively – and successfully – confront current and future public health crises.

*Heidi Larson is Professor of Anthropology, Risk and Decision Science and Director, The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, and Mark Pearson is Deputy-Director for Employment, Labour and Social Affairs, Organisation for Economic Co-operation and Development.