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Promoting Health Equity: A Resource to Help Communities Address Social Determinant of Health

di Laura K. Brennan Ramirez PhD MPH

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This workbook is for public health practitioners and partners interested in addressing social determinants of health in order to promote health and achieve health equity. In its 1988 landmark report, and again in 2003 in an updated report, the Institute of Medicine defined public health as "what we as a society do to collectively assure the conditions in which people can be healthy." Early efforts to describe the relationship between these conditions and health or health outcomes focused on factors such as water and air quality and food safety. More recent public health efforts, particularly in the past decade, have identified a broader array of conditions affecting health, including community design, housing, employment, access to health care, access to healthy foods, environmental pollutants, and occupational safety. The link between social determinants of health, including social, economic, and environmental conditions, and health outcomes is widely recognized in the public health literature. Moreover, it is increasingly understood that inequitable distribution of these conditions across various populations is a significant contributor to persistent and pervasive health disparities. One effort to address these conditions and subsequent health disparities is the development of national guidelines, Healthy People 2010 (HP 2010). Developed by the U.S. Department of Health and Human Services, HP 2010 has the vision of "healthy people living in healthy communities" and identifies two major goals: increasing the quality and years of healthy life and eliminating health disparities. To achieve this vision, HP 2010 acknowledges "that communities, States, and national organizations will need to take a multidisciplinary approach to achieving health equity - an approach that involves improving health, education, housing, labor, justice, transportation, agriculture, and the environment, as well as data collection itself". To be successful, this approach requires community-, policy-, and system-level changes that combine social, organizational, environmental, economic, and policy strategies along with individual behavioral change and clinical services. The approach also requires developing partnerships with groups that traditionally may not have been part of public health initiatives, including community organizations and representatives from government, academia, business, and civil society. This workbook was created to encourage and support the development of new and the expansion of existing, initiatives and partnerships to address the social determinants of health inequities. Content is drawn from Social Determinants of Disparities in Health: Learning from Doing, a forum sponsored by the U.S. Centers for Disease Control and Prevention in October 2003. Forum participants included representatives from community organizations, academic settings, and public health practice who have experience developing, implementing, and evaluating interventions to address conditions contributing to health inequities. The workbook reflects the views of experts from multiple arenas, including local community knowledge, public health, medicine, social work, sociology, psychology, urban planning, community economic development, environmental sciences, and housing. It is designed for a wide range of users interested in developing initiatives to increase health equity in their communities. The workbook builds on existing resources and highlights lessons learned by communities working toward this end.… (altro)
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This workbook is for public health practitioners and partners interested in addressing social determinants of health in order to promote health and achieve health equity. In its 1988 landmark report, and again in 2003 in an updated report, the Institute of Medicine defined public health as "what we as a society do to collectively assure the conditions in which people can be healthy." Early efforts to describe the relationship between these conditions and health or health outcomes focused on factors such as water and air quality and food safety. More recent public health efforts, particularly in the past decade, have identified a broader array of conditions affecting health, including community design, housing, employment, access to health care, access to healthy foods, environmental pollutants, and occupational safety. The link between social determinants of health, including social, economic, and environmental conditions, and health outcomes is widely recognized in the public health literature. Moreover, it is increasingly understood that inequitable distribution of these conditions across various populations is a significant contributor to persistent and pervasive health disparities. One effort to address these conditions and subsequent health disparities is the development of national guidelines, Healthy People 2010 (HP 2010). Developed by the U.S. Department of Health and Human Services, HP 2010 has the vision of "healthy people living in healthy communities" and identifies two major goals: increasing the quality and years of healthy life and eliminating health disparities. To achieve this vision, HP 2010 acknowledges "that communities, States, and national organizations will need to take a multidisciplinary approach to achieving health equity - an approach that involves improving health, education, housing, labor, justice, transportation, agriculture, and the environment, as well as data collection itself". To be successful, this approach requires community-, policy-, and system-level changes that combine social, organizational, environmental, economic, and policy strategies along with individual behavioral change and clinical services. The approach also requires developing partnerships with groups that traditionally may not have been part of public health initiatives, including community organizations and representatives from government, academia, business, and civil society. This workbook was created to encourage and support the development of new and the expansion of existing, initiatives and partnerships to address the social determinants of health inequities. Content is drawn from Social Determinants of Disparities in Health: Learning from Doing, a forum sponsored by the U.S. Centers for Disease Control and Prevention in October 2003. Forum participants included representatives from community organizations, academic settings, and public health practice who have experience developing, implementing, and evaluating interventions to address conditions contributing to health inequities. The workbook reflects the views of experts from multiple arenas, including local community knowledge, public health, medicine, social work, sociology, psychology, urban planning, community economic development, environmental sciences, and housing. It is designed for a wide range of users interested in developing initiatives to increase health equity in their communities. The workbook builds on existing resources and highlights lessons learned by communities working toward this end.

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