The Latest Hot Topic in Public Health: Social Determinants

Date: October 7th, 2014
By:

Pat Paluzzi

Considering the impact of social determinants on population health and well-being is not new, but there is a resurgence of interest in how to actualize this idea. The Healthy People 2020 Objectives include social determinants for the first time:

“Healthy People 2020 highlights the importance of addressing the social determinants of health by including ‘Create social and physical environments that promote good health for all’ as one of the four overarching goals for the decade. This emphasis is shared by the World Health Organization, whose Commission on Social Determinants of Health in 2008 published the report, Closing the gap in a generation: Health equity through action on the social determinants of health. The emphasis is also shared by other U.S. health initiatives such as the National Partnership for Action to End Health Disparities and the National Prevention and Health Promotion Strategy. They define social determinants of health as ‘conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.’”

The World Health Organization has long held the stance that incorporating social determinants is essential to effect equality and justice among the world’s populations. The Center for Disease Control and Prevention (CDC) has also embraced the promotion of social determinants and recently published a white paper addressing the need to incorporate social determinants to impact changes in certain communicable diseases. (In 2010, CDC published an NCHHSTP White Paper on Social Determinants of Health called Establishing a Holistic Framework to Reduce Inequities in HIV, Viral Hepatitis, STDs, and Tuberculosis in the United States.)

Healthy Teen Network has fully embraced the need to incorporate social determinants into adolescent sexual and reproductive health, including when supporting pregnant and parenting teens. We have long recognized the need to expand our thinking to include environment and circumstances when addressing the needs of the most marginalized (and thus at risk) youth.

Education and access to services, including evidence-based programs or interventions, are necessary but not sufficient to address the persistent gaps in the rates we see across youth populations in the US. Assessing and addressing the basic needs of the most challenged youth is a necessary step in reducing risky behaviors. Healthy Teen Network believes we must look at youth from the vantage of social determinants first and risky behaviors second and will promote this approach moving forward. This is clearly reflected in our Strategic Plan, 2013-2106: Road Map for the Future of Adolescent Sexual and Reproductive Health.

Healthy Teen Network has selected three social determinant categories to focus on:

  1. access to education, employment,  and economic opportunity,
  2. access to healthcare, and
  3. social norms and culture.

These three were prioritized based on findings from the field (i.e., what our constituents tell us is most needed as well as scientific research findings), current trends in demographics and youth behavior, organizational capacity, and alignment with our Mission. Moving forward, Healthy Teen Network will examine these determinants as to how they affect our populations of interest and develop resources that build the capacity of the field to integrate them into current and future efforts.

We hope you will take the time to read the Strategic Plan, peruse the interactive presentation using Prezi, and comment on our thinking. Sharing your concerns, support, and examples of similar efforts helps us all. Join us in Savannah, Georgia, October 22-23, 2013 as we further explore how to integrate social determinants into our work and make a difference in the lives of ALL youth.

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About the Author

Patricia Paluzzi, CNM, DrPH, President and CEO of Healthy Teen Network, has been active in the fields of reproductive, and maternal and child health for over 40 years, as a clinician, researcher, administrator, and advocate. Her clinical and content expertise spans the full scope of midwifery care, substance abuse, intimate partner violence, high-risk maternal child health (including pregnant teens), incorporating men into clinical services, and trauma-informed approaches.

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