Threading Policy and Community Approaches to Advance Health Equity

Roger Figueroa, PhD, MPH, MSc - SBM Advocacy Council

In March 2025, hundreds within the Society of Behavioral Medicine (SBM) will gather in San Francisco to discuss why context matters, bridging perspectives in Behavioral Medicine. One such context is policy, where SBM members have been leading the way translating evidence to close research-to-policy translation gaps through Advocacy Council activities like the Health Policy Ambassadors Program. As my term as the SBM Advocacy Council Chair comes to an end, I thought I could use our upcoming conference theme to hint at how we may continue advancing our advocacy work as SBM members (whether as advocates, private citizens, scientists and/or on behalf of SBM). 

As a new federal administration approaches in the United States (U.S.), it is important to remember that elected officials have the primary responsibility of serving their constituents.¹ For example, U.S. elected officials draft and enact legislation that shapes conditions in which people live, study, work, access nutritious food, water, and housing; and connect with their social network.² So, when policies fail to distribute resources equitably across communities, these conditions turn inequitable and contribute to disparities in health conditions.

Sometimes it is hard to make ends meet or simply not know where the next meal will come from. This is when turning to public and social services for assistance to access community resources can support people’s livelihoods and wellbeing. It is well known that nations that spend more on social services, (i.e., disability, unemployment, housing) relative to their gross domestic product have significantly better population health outcomes.³ But when policies lead to community disinvestments, it hinders quality living and working conditions that adversely impact community health.

I would like to think of the Infrastructure Investment and Jobs Act (IIJA)⁴ as an example going forward. Approximately three years ago, President Biden signed this historic legislation into law. This once-in-a-generation investment is expected to strengthen our infrastructure while tackling the climate crisis, improving transportation services, and creating new jobs nationwide, among others. As progress is made to translate this policy into action at the community, organizational, and household levels, our advocacy efforts can continue to keep track of progress made to ensure the funding and resources committed to accomplish the IIJA goals meet expectations. Similarly, we have an opportunity to identify gaps in conditions and services in our communities, whether through policy advocacy or innovative research.¹ Finding ways to ensure new information becomes available to inform policy actions can improve these conditions and services, which is critical to the work ahead.

Returning to why context matters, it is important to recognize that communities operate in the context of federal and state policies that can affect local government decisions relevant to health through laws and regulations, through the allocation of resources, and by shaping political will on issues and approaches.⁵ I extend an open invitation to my fellow SBM members to remain engaged in our key policy priorities (i.e., climate change and health, child nutrition, and pain management/opioid use) to advocate on behalf of communities to advance health equity.

References:

1. Figueroa, R., & Verma, R. (2023). Constituent-driven health policy informed by policy advocacy literature. Translational Behavioral Medicine, 13(5), 338-342.
2. Baciu, A., Negussie, Y., Geller, A., & Weinstein, J. N. (Eds.). (2017). Communities in action: Pathways to health equity.
3. Shrank, W. H., Keyser, D. J., & Lovelace, J. G. (2018). Redistributing investment in health and social services—the evolving role of managed care. JAMA, 320(21), 2197-2198.
4. The White House. (2021). Fact Sheet: The Bipartisan Infrastructure Deal. Retrieved from: https://www.whitehouse.gov/briefing-room/statements-releases/2021/11/06/fact-sheet-the-bipartisan-infrastructure-deal/
5. Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., & National Academies of Sciences, Engineering, and Medicine. (2017). Policies to Support Community Solutions. In Communities in Action: Pathways to Health Equity. National Academies Press (US).