Unintended consequences of social and economic policies for population health: towards a more intentional approach.

Over the last decade there has been a growing interest in exploring the unanticipated health impacts of social and economic policies designed mainly to improve well-being, reduce discrimination, maintain family stability and improve mobility for disadvantaged populations. Since many of these policies are closely linked to the channels through which ‘social determinants’ may impact health, this is an intuitively appealing and in fact, compelling area of investigation. In addition, many evaluations of such policies have strong experimental elements, thereby avoiding some of the downfalls of observational studies where selection undermines our ability to make causal inferences. However, these evaluations have not been without significant problems. I outline three reasons to conduct this work and another three challenges to the interpretability of results.