In a series of recent peer-reviewed journal articles, Nationhood Lab and its research collaborators presented the American Nations model and its utility for understanding U.S. health patterns
In addition to its data journalism and national narrative work, Nationhood Lab engages in peer-reviewed academic research, collaborating on twenty-five papers published over as many months. While the project has worked with political scientists, geographers, and anthropologists, the thrust of the research to date has been on identifying geographic differences in various U.S. health indices and providing the regional cultural factors involved.
The big lesson: regions with a more communitarian oriented cultures are healthier, happier, safer, and longer lived than those with a strong emphasis on individualism. This is because culture influences political choices which, in turn, effect the social determinants of health and, thus, health outcomes. Investing in people, infrastructure, education and health – the data shows – makes for a healthier population.
Project director Colin Woodard was the lead author of the latest paper, “The American Nations Model: An Analytical Tool for Understanding the Influence of U.S. Regional Cultures on Health and the Social and Political Determinants of Health” — published in the forthcoming issue of Progress in Cardiovascular Diseases, one of the country’s leading academic journals in that field. Woodard and his co-authors, Ross Arena of the University of Illinois Chicago and Nicolaas Pronk, president of the Minneapolis-based HealthPartners Institute, laid out the American Nations model for health and medical researchers.
“Political acts…create regional social, political and economic conditions that affect behavoiral choices and decisions made by groups and individuals,” Woodard wrote. “Regional ideologies also effect key social determinants of health, including social trust, the availability of social capital, and social cohesion.”
The paper was part of a special issue of Progress in Cardiovascular Diseases devoted to the cultural effects on health outcomes, which included a lead editorial and a paper laying out a detailed ecosystem-type model on the links between culture and health outcomes, both of which included Pronk, Arena and Woodard as authors. “We place culture (i.e. dominant cultural norms of geographical regions) at the pinnacle of this framework,” lead author Pronk wrote of the ecosystem framework, which incorporates the American Nations model. “Based on the literature, we conclude that culture is an overwhelming determinant of both individual- and social-level health behaviors and habits because it profoundly influences the political realities and power dynamics of a community and creates the infrastructure and policy environments in which people conduct their lives.”
In a fourth article, published in March in Current Problems in Cardiology, the three researchers joined the University of Illinois Chicago’s Shuajie Wang and Tanvi Bhatt to test the aforementioned ecosystem model through the use of artificial intelligence. The non-linear A.I. statistical approach demonstrated the efficacy of the model — a “proof of concept” — for predicting life expectancy, the death rate, and years of life lost in a particular geographical space. The team used a similar technique to demonstrate the ecosystem model’s validity for explaining variability in obesity and physical inactivity rates, publishing their findings last week in the American Journal of Medicine.
Over the past two years, the three researchers and their collaborators have used Woodard’s American Nations model to reveal and explain the spatial patterns of a wide range of health indices, including the prevalence of diabetes, obesity, disabilities, arthritis and preventable oral health problems, and have presented their work at the National Academies.