Shift toward social determinants transforming public health work: Targeting causes of health disparities

Understanding the complex factors that make up a healthy community is essential to the work of public health and its mission to improve health across the lifespan.  In Jefferson County, Healthy Jeffco, is a network comprised of over 300 community partners, working across seven coalitions to address the many factors that contribute to the health of our communities including: employment, housing, economy, education, access to healthy food, active living, transportation, mental health and health care. Where you live, work and play really do matter when it comes to health, more than you may imagine. Learn more from this article by Kim Krisberg from the American Public Health Association’s monthly newsletter, The Nation’s Health.

First in a series on the role of social determinants of health. Visit www.thenationshealth.org/sdoh for related content.

Several years ago, public health workers in Wayne County, Michigan, embarked on a new endeavor to tackle infant mortality, an issue that affected the community’s black newborns at more than twice the rate of white newborns.
But instead of looking to medicine for answers, workers headed upstream to confront social determinants that put black babies at a disadvantage long before conception occurs.

“We wanted to focus on education, employment, social isolation, structural racism — all those factors combined correlate to an unfavorable birth outcome and the chances of a child not celebrating his or her first birthday,” APHA member Mouhanad Hammami, MD, director of the Wayne County Department of Health, Veterans and Community Wellness, told The Nation’s Health. “What happens from the time a girl is born to the time she has a child?”
The Wayne County approach is complex, slow moving and requires buy-in from multiple sectors, but Hammami said public health “cannot continue to do business as usual.”

Among the first steps, he said, was reaching across sectors to educate public officials about their role in health. For instance, when Hammami first asked local transportation authorities for help in reducing infant mortality, he said “they laughed — they said ‘we’re not a health department.’” But Hammami persisted, explaining that for many women, transportation was a major barrier to prenatal care. Now, health and transportation officials work together to make women aware of their transportation options, such as shuttles that can be scheduled in advance.

>> link to entire story in Our Nations Health