What are Social Determinants of Health?
The Centers for Disease Control identify the following non-medical factors that determine our community health:
- How a person develops during the first few years of life (early childhood development)
- How much education a person obtains
- Being able to get and keep a job
- What kind of work a person does
- Having food or being able to get food (food security)
- Having access to health services and the quality of those services
- Housing status
- How much money a person earns
- Discrimination and social support
What is Community Health?
Walter Cronkite famously observed that “America’s health care system is neither healthy, caring, nor a system.” From its incorporation in 2002, the North Colorado Health Alliance has been dedicated to the reform of this trend. By systematically caring for the health of underserved populations in Weld and Larimer counties, Alliance partner organizations have knit an exemplary safety net.
And yet, significant gaps persist. Extensive studies of individual and population health reveal that only about ten percent (link to person/rx bottle infograph) of our overall health is directly related to the health care sector of our economy. Of far greater significance to our health are our behaviors as individuals and a myriad of non-medical factors which influence our behavior and contribute to our vulnerability. The World Health Organization (WHO) has defined these non-medical factors as “the conditions in which people are born, grow, live, work and age” and proceeds to assert that “these circumstances are shaped by the distribution of money, power and resources at global, national and local levels.”
Working at the community level to promote healthy living and prevent chronic disease brings the greatest health benefits to the greatest number of people in need. It also helps to reduce health gaps caused by differences in race and ethnicity, location, social status, income, and other factors that can affect health. (http://www.cdc.gov/nccdphp/dch/about/benefits_community_health.htm)
What is Public Health?
Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases. Thus, public health is concerned with the total system and not only the eradication of a particular disease. The three main public health functions are:
- The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities.
- The formulation of public policies designed to solve identified local and national health problems and priorities.
- To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services.
What are Health Disparities?
Although the term disparities is often interpreted to mean racial or ethnic disparities, many dimensions of disparity exist in the United States, particularly in health. If a health outcome is seen to a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health. It is important to recognize the impact that social determinants have on health outcomes of specific populations. (http://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities)
What is Health Equity?
Equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. Health inequities therefore involve more than inequality with respect to health determinants, access to the resources needed to improve and maintain health or health outcomes. They also entail a failure to avoid or overcome inequalities that infringe on fairness and human rights norms.
Reducing health inequities is important because health is a fundamental human right and its progressive realization will eliminate inequalities that result from differences in health status (such as disease or disability) in the opportunity to enjoy life and pursue one’s life plans.
A characteristic common to groups that experience health inequities—such as poor or marginalized persons, racial and ethnic minorities, and women—is lack of political, social or economic power. Thus, to be effective and sustainable, interventions that aim to redress inequities must typically go beyond remedying a particular health inequality and also help empower the group in question through systemic changes, such as law reform or changes in economic or social relationships. (http://www.who.int/healthsystems/topics/equity/en/)
What is meant by Health Outcome?
An ideal population health outcome metric should reflect a population’s dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. (http://www.cdc.gov/pcd/issues/2010/jul/10_0005.htm)
What is a Community Health Worker?
A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy. (https://www.apha.org/apha-communities/member-sections/community-health-workers)