Key Definitions:
- health: the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity1
- health equity: the attainment of the highest level of health for all people2
- health inequities: systematic differences in the health status of different population groups; refers to unfair and avoidable inequalities that are not inevitable or natural, but the product of human behavior3 4
- health disparities: preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations5
- social determinants of health (SDOH): conditions in the environment where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life-outcomes and risks6
- underserved communities: populations sharing a particular characteristic, as well as geographic communities, that have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life7
- Health in All Policies (HiAP): a collaborative approach that integrates and articulates health considerations into policymaking across sectors to improve the health of all communities and people8
White Papers
Innovations to Address Social Determinants of Health
February 2023
What We’re Currently Reading:
1. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016
This study analyzed key population health concepts and examined major empirical trends in U.S. health and healthcare inequalities from 1935 to 2016. The main finding was that, despite the overall health improvement in the eight decades, significant social disparities remain in many health indicators. The most notable indicators are life expectancy and infant mortality. Health inequalities are widening among Americans, and a multisectoral approach is needed to tackle the issue.9
2. Moving Toward Health Equity by Addressing Social Determinants of Health
This article discusses social determinants of health (SDOH) from the nursing perspective, concentrating on the effects of different SDOH on women. Many of the article’s references discuss different social determinants and the impact they have on the health of the body. Factors that produce extreme physical and emotional stress include poverty, unsafe living conditions, food insecurity, oppression, abuse, and racism. Conclusions about the research question bring up a proposed new screening process that includes nurses’ lived experiences, health knowledge, and strengths in patient advocacy within the healthcare system and beyond.10
3. Developing a Database of Structural Racism-Related State Laws for Health Equity Research and Practice in the United States
The authors developed a database of 823 State laws that are explicitly or implicitly structurally racist. Legal domains included voting rights, stand-your-ground laws, racial profiling laws, mandatory minimum sentencing laws, immigrant protections, fair-housing laws, minimum-wage laws, predatory lending laws, school punishment laws, and stop-and-identify laws. Eventually, this database could be used to explore the association between those laws and health outcomes among marginalized racial/ethnic groups.11
4. A tool to assess alignment between knowledge and action for health equity
This resource describes a tool that can assess alignment between knowledge and action for health equity. Acknowledging the paradox that good intentions and good evidence do not necessarily lead to meaningful action, the tool presents six possible actions that describe ways in which health equity work could respond to causes of health inequities:
-
- Discredit
- Distract
- Disregard
- Acknowledge
- Illuminate
- Disrupt
Any kind of health equity work can be assessed or informed in different settings and at different levels of intervention. The tool is a great way of holding practice, policy, or research accountable, encouraging steps toward equity- and evidence-informed action.12
5. Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health
As technology, health informatics, and digital health innovations explode in power, reach, and influence, there is the potential for this expansion to negatively impact and possibly exacerbate healthcare disparities for underserved (and under-resourced) populations. The paper describes several case studies of digital innovation that are examples of “digital redlining” or failure of app developers to ensure comprehensive reach and useability. Examples of community-engaged digital innovation are provided as a positive model for reducing these barriers and advancing health equity.13
Past Econometrica Media:
See Econometrica’s Recent Blog Posts for more Health Equity Facts and Resources:
Housing Instability Has an Inverse Relationship with Mental Illness, July 8, 2022
Housing Impacts on Maternal Health, July 21, 2022
Health Equity and Cancer, August 5, 2022
Overweight and Obesity, August 16, 2022
Acknowledgments:
3 https://pubmed.ncbi.nlm.nih.gov/16533114/
4 https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes
5 https://www.cdc.gov/healthyyouth/disparities/index.htm#:~:text=Health%20disparities%20are%20preventable%20differences,experienced%20by%20socially%20disadvantaged%20populations
6 https://health.gov/healthypeople/priority-areas/social-determinants-health
7 https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racial-equity-and-support-for-underserved-communities-through-the-federal-government/
9 Singh, G. K., Daus, G. P., Allender, M., Ramey, C. T., Martin, E. K., Perry, C., Reyes, A., & Vedamuthu, I. P. (2017).
Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016. International journal of MCH and AIDS, 6(2), 139–164. https://doi.org/10.21106/ijma.236
10 Lathrop, B. (2020). Moving toward health equity by addressing Social Determinants of Health. Nursing for Women’s Health, 24(1), 36–44. https://doi.org/10.1016/j.nwh.2019.11.003
11 Agénor, M., Perkins, C., Stamoulis, C., Hall, R. D., Samnaliev, M., Berland, S., & Bryn Austin, S. (2021). Developing a database of structural racism–related state laws for Health Equity Research and practice in the United States. Public Health Reports, 136(4), 428–440. https://doi.org/10.1177/0033354920984168
12 Plamondon, K.M. A tool to assess alignment between knowledge and action for health equity. BMC Public Health 20, 224 (2020). https://doi.org/10.1186/s12889-020-8324-6
13 Brewer L, Fortuna K, Jones C, Walker R, Hayes S, Patten C, Cooper L
Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health JMIR Mhealth Uhealth 2020;8(1):e14512 https://mhealth.jmir.org/2020/1/e14512 10.2196/14512