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Abstract Previous research findings across a variety of nations show that affiliation with the conservative party is associated with greater longevity; however, it is thus far unclear what characteristics contribute to this relationship. We examine the political party/mortality relationship in the United States context. The goal of this paper is two-fold: first, we seek to replicate the mortality difference between Republicans and Democrats in two samples, controlling for demographic confounders. Second, we attempt to isolate and test two potential contributors to the relationship between political party affiliation and mortality: (1) socioeconomic status and (2) dispositional traits reflecting a personal responsibility ethos, as described by the Republican party. Graduate and sibling cohorts from the Wisconsin Longitudinal Study were used to estimate mortality risk from 2004 to 2014. In separate Cox proportional hazards models controlling for age and sex, we adjusted first for markers of socioeconomic status (such as wealth and education), then for dispositional traits (such as conscientiousness and active coping), and finally for both socioeconomic status and dispositional traits together. Clogg's method was used to test the statistical significance of attenuation in hazard ratios for each model. In both cohorts, Republicans exhibited lower mortality risk compared to Democrats (Hazard Ratios = 0.79 and 0.73 in graduate and sibling cohorts, respectively [p < 0.05]). This relationship was explained, in part, by socioeconomic status and traits reflecting personal responsibility. Together, socioeconomic factors and dispositional traits account for about 52% (graduates) and 44% (siblings) of Republicans' survival advantage. This study suggests that mortality differences between political parties in the US may be linked to structural and individual determinants of health. These findings highlight the need for better understanding of political party divides in mortality rates. Highlights • Republicans have greater longevity compared to Democrats, adjusting for demographics. • This relationship is partly explained by Republican's higher socioeconomic status. • This relationship is partly explained by Republican's personal responsibility ethos. [ABSTRACT FROM AUTHOR]

Previous studies have shown that financial turbulence is associated with a short-term increase in road traffic collisions, largely due to drivers' emotional state, distraction, sleep deprivation and alcohol consumption. In this paper we advance this debate by studying the association between economic uncertainty and road traffic mortality in the United States. We used a State-level uncertainty index and State fatalities for the period 2008–2017 and found that a one standard deviation increase in economic uncertainty is associated with an additional 0.013 monthly deaths per 100,000 people per State, on average (a 1.1% increase) - or 40 more monthly deaths in total nationwide. Results are robust to different model specifications. Our findings show that, similar to drink-driving, it is important to raise awareness about driving when distracted due to financial worries and during periods of economic uncertainty. • Financial turbulence has been associated with an increase in road traffic collisions. • We study the link between economic uncertainty and road traffic mortality in the US. • A one standard deviation increase in uncertainty is linked to 1.1% higher mortality. [ABSTRACT FROM AUTHOR]

There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986 to 2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a “one-policy, one-level, one-outcome” approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health. [ABSTRACT FROM AUTHOR]

Increasing “patient engagement” has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. This paper uses 20 months of ethnographic and interview research carried out from 2015 to 2016 to explore how health care providers working at two public, urban, safety-net hospitals in the United States define, discuss, and assess patient engagement. We investigate how health care providers describe engagement for high cost patients—the “super-utilizers” of the health care system—who often face complex challenges related to socioeconomic marginalization including poverty, housing insecurity, exposure to violence and trauma, cognitive and mental health issues, and substance use. The health care providers in our study faced institutional pressure to assess patient engagement and to direct care towards engaged patients. However, providers considered such assessments to be highly challenging and oftentimes inaccurate, particularly because they understood low patient engagement to be the result of difficult socioeconomic conditions. Providers tried to navigate the demand to assess patient engagement in care by looking for explicit positive and negative indicators of engagement, while also being sensitive to more subtle and intuitive signs of engagement for marginalized patients. [ABSTRACT FROM AUTHOR]