Dr_Candice

Ten Essential Public Health Services and How They Can Include Addressing Social Determinants of Health Inequities

Public health departments and their partners need to consider how conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. These social determinants of health (SDOH), and actions to address the resulting health inequities, can be incorporated throughout all aspects of public health work. Through broader awareness of how the key public health practices can better incorporate consideration of SDOH, public health practitioners can transform and strengthen their capacity and impact to advance health equity.

10 Essential Public Health Services Five Key Areas of SDOH (HP 2020)

Roles of Public Health Agency (Based on 10 Essential Public Health Services)

Examples of How Essential Public Health Services Can Address SDOH Inequities

1. Monitor health status to identify and solve community health problems

Include SDOH measures as basis for addressing community health problems and inequities

Ensure community health assessments (CHA) include SDOH measures and engage communities and multi-sectoral partners in CHA efforts

2. Diagnose and investigate health problems and health hazards in the community

Include community-level determinants of health in investigations, as well as policies and practices that involve other sectors to support them. For example

 Ensure water sources meet required standards

 Ensure brownfield sites Identify hazardous waste that might contaminate a community

 Address deteriorating housing conditions to prevent lead poisoning and other hazards to health

3. Inform, educate, and empower people about health issues

Ensure outreach and education efforts address social and structural determinants of health inequities

Ensure access to culturally and linguistically appropriate approaches to community health (e.g., REACH) to help address SDOH. Approaches should take into account such challenges as structural racism and stigma against

immigrants, both of which can decrease likelihood of seeking needed health care.

4. Mobilize community partnerships and action to identify and solve health problems

Engage and collaborate with community members and non-traditional partners associated with SDOHs, such as

 Housing authorities

 Law enforcement

 Schools

 Community organizations

5. Develop policies and plans that support individual and community health efforts

Leverage evidence-based policies in non-health sectors that affect SDOH and health outcomes, such as

 Safe and affordable housing that can reduce risk for asthma, lead poisoning, homelessness

 Full-day kindergarten that can reduce adverse health prospects such as teenage pregnancy

Develop and implement state/community health improvement plans that include and address the SDOH in collaboration with community partners

6. Enforce laws and regulations that protect health and ensure safety

Develop strategies to ensure enforcement of existing regulations and laws that affect health, such as

 Housing and health codes to prevent childhood lead poisoning.

 Batterer intervention program laws to prevent violence against women and children

7. Link people to needed personal health services and ensure the provision of health care when otherwise unavailable

Educate community members about their eligibility for and access to entitlement programs

 Medicaid, including its medical, mental health, and housing benefits

 TANF

 SNAP

Ensure that essential health benefits and the free preventive services provisions of the Affordable Care Act are correctly and equitably implemented

8. Assure competent public and personal health care workforce

Support staff training and development efforts that help workforce incorporate social determinants of health inequity into their job responsibilities

Promote hiring of workforce that reflects population being served

9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services

Ensure evaluation and research designs include interventions that address SDOH inequity

Use performance management and quality improvement methods to explore and address more effectively the root causes of issues, which often include SDOH

10. Research for new insights and innovative solutions to health problems

Expand research agendas to include SDOH and related health outcomes, especially in evaluation of natural experiments where a project is already addressing SDOH but is not studying health effects (e.g., implementation of the Essentials for Childhood Framework)

Use community-based participatory research designs

Apply evidence-based practices (e.g., The Community Guide) to address health inequity and demonstrate improved health outcomes

Visit the CDC website to learn more about social determinants of health.