Social Determinants of Health

Group III A

Building Strong, Healthy Communities

Social Determinants of Health

“The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system.

These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices.”

WHO, 2009

Proportional Contribution to Premature Death

McGinnis, Social Determinants of Health, 2002

Problem StatementNot all communities have the resources to help their citizens live healthy & productive lives.

Rationale

Health problems are intimately connected to societal and behavioral concerns, including poverty, substance abuse, family and community violence, inadequate housing, education, and transportation, poor chronic disease care, social isolation, and lack of preventive services.

Rationale

NEJM, Schroeder, 2007

Numbers of U.S. Deaths from Behavioral Causes, 2000

Rationale

Community-based worker models have been very effective at capacity building and improving population health outcomes, such as Promotoras, AmeriCorps, Teach America, and Habitat for Humanity

Proposed SolutionExpand the capacity of communities to address current and future health problems by training, mentoring, and funding of workers within the community. Community workers would act as coordinators and build coalitions to link and expand existing services, facilitate access to resources such as WIC, health care, job training, and housing information.

Stakeholders--Partners

• National Association of Community Health Centers

• National Association of Education of Young Children

• Faith-based agencies• State and local health departments

Stakeholders--Supporters

• AmeriCorps• HeadStart• Children’s Defense Fund• March of Dimes• National Education Association• APHA

Stakeholders--Supporters

• American Nursing Association• National Black Nurses Association• National Hispanic Nurses Association• Families USA• Association of State and Territorial

Health Officials• American Association for Health

Education

Stakeholders--Opposition

• Heritage Foundation• American Conservative Union• Citizens United• Conservative Caucus• Education programs may prefer

direct allocations

Plan of ActionSeek sponsorship on a federal level to expand AmeriCorps (current FY08 appropriation is $380 million)

• Senate Committee on Health, Education, Labor, & Pensions: Lead sponsor, Kennedy (MA) or Dodd (CT)

• House Committee on Education and Labor: Lead Sponsor, McCarthy (NY)

• Seek bipartisan support, i.e. Hatch (UT), McCain (AZ)