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Amanda Merck

Merck completed her MPH with a concentration in Physical Activity and Health. She curates content for Salud America! (@SaludAmerica), a Latino childhood obesity prevention project based at the Institute for Health Promotion Research at UT Health San Antonio. She focuses on the latest research, resources, and stories related to policy, systems, and environmental changes to enhance equitable access to safe places for kids and families to walk, bike, and play.


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Articles by Amanda Merck

As Social Need Screening Advances, Transportation Remains an Afterthought


As Social Need Screening Advances, Transportation Remains an Afterthought

Some big changes in 2022 and 2023 have set up the healthcare sector to advance screening for non-medical social needs in 2024 and beyond. This is great news as we work to address social determinants of health (SDoH), improve health outcomes, and reduce health disparities. But one key social need – transportation – isn’t getting the attention it deserves. Transportation is a foundational social need and often co-occurs with other needs and/or acts as a barrier to resolving other needs. Yet transportation is often poorly conceptualized, thus is poorly operationalized in social need screening tools and related justifications. In this post, we review the following big changes as they relate to transportation as a SDOH: Big Change 1: In 2022, the Centers for Medicare ...

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Hit or Miss? The Updated Federal Rules on Roadway Traffic Control


Manual on Uniform Traffic Control Devices for Streets and Highways (MUTCD).

In December 2023, the Federal Highway Administration (FHWA) released the final rule adopting the nearly 1,200-page 11th Edition of the Manual on Uniform Traffic Control Devices for Streets and Highways (MUTCD). The MUTCD is the national standard for all road marking, highway signs, and traffic signals. Three years prior, the FHWA requested public comments on the proposed changes to the then-700-page MUTCD, which hadn’t been updated since 2009. More than 25,000 people submitted public comments. That included nearly 450 of the model comments developed by our team at Salud America! at UT Health San Antonio. Let’s explore how the FHWA hit the mark for improvement (or missed an opportunity) for five key areas of concern in our model comments and those of other transportation ...

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Stormee Williams: Helping Screen Families for Social Needs in Dallas



At her annual wellness visit, Dr. Stormee Williams filled out a digital questionnaire that asked about her need for help with housing, transportation, food access, and other non-medical needs. Williams was taking an “SDoH Screener.” An SDoH screener is a questionnaire to help healthcare workers identify a patient’s issues with the social determinants of health (SDoH), the conditions in which people are born, grow, work, live, and age, and the wider set of social, economic, and political systems that shape life. If a screener finds a patient in need, healthcare workers can then connect the patient to community support and resources. Helping patients address these non-medical needs can help them achieve better health. Williams, fortunately, didn’t have non-medical ...

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Why are Other Nations Outperforming America on Health Outcomes?


Why are Other Nations Outperforming America on Health Outcomes

Spending on health is rising in America. Yet, ironically, health outcomes are getting worse. In fact, people here experience the worst health outcomes overall of any high-income nation. U.S. residents are more likely to die younger, and from avoidable causes, than residents of peer countries, according to a 2023 report from The Commonwealth Fund. Let’s compare health outcomes with peer countries to provide an important baseline for where we are in health outcomes and set a target for where we could be. The U.S. and 5 Important Domains of Healthcare Systems A 2021 study by The Commonwealth Fund compared five performance domains of health care systems across 11 high-income countries. Researchers found the U.S. ranks last on four of five domains: access to care (last) ...

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#SaludTues 10/3/2023: Addressing Inadequate Transportation to Improve Health


Addressing Inadequate Transportation to Improve Health

Many Americans face transportation barriers that threaten quality of life. When burdened by transportation costs and lack of safe, feasible options, families are forced to make tradeoffs, such as foregoing spending on food and medications or skipping trips to essential destinations such as medical care, the grocery store, workforce development, and other resources, and services. Inadequate transportation not only contributes to inequities in health but also contributes to inequities in social and economic outcomes which exacerbate inequities in health. To reduce inequities and improve overall health, we need both individual-level and community-level strategies to mitigate the symptoms and consequences of inadequate transportation. Let’s use #SaludTues on October 3, 2023, ...

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Nearly 3,000 Comments to NHTSA About Considering Pedestrians in Vehicle Safety Ratings


NCAP Share the Real Risk to Pedestrians in Vehicle Safety Ratings (1)

The National Highway Traffic Safety Administration (NHTSA) is proposing to consider pedestrians in their vehicle safety rating system. That is good news for a system that has ignored the safety of people outside the vehicle wherein "pedestrian fatalities have skyrocketed 77% since 2010, compared to 25% for all other traffic-related deaths," according to preliminary data from the Governors Highway Safety Association (GHSA). But the news isn’t all good. NHTSA’s proposed changes to the vehicle safety rating system – the New Car Assessment Program (NCAP) – are insufficient. The changes do not differentiate between pedestrian injury risk and fatality risk, and they fail to fully inform consumers about the true risk to pedestrians from vehicles, lessening the potential ...

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UPDATE: Health Equity Report Card Covers Child Opportunity, Location Affordability, Transit Access


UPDATE: Health Equity Report Card Covers Child Opportunity, Location Affordability, Transit Access

We have updated our Salud America! Health Equity Report Card to cover your county’s child opportunity score, environmental justice score, location affordability, and transit access. The Health Equity Report Card, first launched in 2017, auto-generates Latino-focused and local data with interactive maps and comparative gauges, which can help you visualize and explore local inequities in housing, transit, poverty, health care, food, education, and more. You will see how your county stacks up in these health equity issues — now including child opportunity, location affordability, and transit access — compared to your state and the nation. Then you can share the Report Card with your local leaders to shift from individualist thinking to advocating for systemic community change ...

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#SaludTues 6/6/2023: Why and How to Nurture Civic Health


Why and How to Nurture Civic Health

Civic health is the ability to participate in one’s community and be involved in the decision-making process, from voting and advocacy to mentoring and volunteering. However, some places face more structural barriers to civic health, which threatens democracy. Structural barriers are policies and practices that create or maintain unfair and unjust outcomes and they also threaten health equity. Let’s use #SaludTues on June 6, 2023, to tweet about how policies, practices, and people can improve civic space and foster shared decision-making, so all people have the opportunity to meaningfully shape decisions that affect their communities. WHAT: #SaludTues Tweetchat: “Why and How to Nurture Civic Health” TIME/DATE: 1-2 p.m. ET Tuesday, June 6, 2023 WHERE: On ...

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We Need More Complete Data on Social Determinants of Health


We Need More Complete Data on Social Determinants of Health

Data can drive action for healthy change. But what if we don’t have enough data? Or the right data? Or equitable data? Unfortunately, even with more health reports and more health dashboards than ever before, we still face inconsistent and incomplete data. We are lacking sufficient data – especially data disaggregated by race/ethnicity – on social determinants of health, firearm violence, traffic crashes, and adverse childhood experiences. Insufficient data happens for many reasons. Limited funding, limited staff, uncertain methods, logistical challenges, entrenched practices, inadequate analysis, and inadequate or non-uniform reporting after data collection are occurring at the local, state, and federal levels. Let’s explore the most critical missing data and how ...

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