Trends in U.S. Population Health: The Central Role of Policies, Politics, and Profits

Jennifer Karas Montez, Mark D. Hayward, Anna Zajacova

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Recent trends in U.S. health have been mixed, with improvements among some groups and geographic areas alongside declines among others. Medical sociologists have contributed to the understanding of those disparate trends, although important questions remain. In this article, we review trends since the 1980s in key indicators of U.S. health and weigh evidence from the last decade on their causes. To better understand contemporary trends in health, we propose that commonly used conceptual frameworks, such as social determinants of health, should be strengthened by prominently incorporating commercial, political-economic, and legal determinants. We illustrate how these structural determinants can provide new insights into health trends, using disparate health trajectories across U.S. states as an example. We conclude with suggestions for future research: focusing on structural causes of health trends and inequalities, expanding interdisciplinary perspectives, and integrating methods better equipped to handle the complexity of causal processes driving health trends and inequalities.

Original languageEnglish (US)
Pages (from-to)286-301
Number of pages16
JournalJournal of health and social behavior
Issue number3
StatePublished - Sep 2021


  • commercial
  • inequalities
  • legal
  • political
  • trends

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health


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