1. October 31, 2014 Jenny Miller DrPH MS MPH
Interdisciplinary Approaches to Health Issues in Alaska: Social Determinants of Health
October 31, 2014
Jenny Miller DrPH MS MPH

2. Objectives Provide an overview of the social determinants of health
Present the social determinants of health as an overarching framework for health issues in Alaska
Explore how the social determinants of health are applied in health research

3. Healthy People 2020: One of four overarching goals for the decade
Create social and physical environments that promote good health for all

4. Health begins in our: Homes Schools Workplaces Neighborhoods
Communities

5. World Health Organization
Closing the gap in a generation: Health equity through action on the social determinants of health, 2008

6. Social Determinants of Health

7. Institute of Medicine Model: A guide to thinking about the determinants of population health

8. Five Key Areas (Determinants)
Economic Stability
Education
Social and Community Context
Health and Health Care
Neighborhoods and the Built Environment

9. Examples of Social Determinants
Availability of resources to meet daily needs e.g., food markets, safe housing
Access to educational, economic and job opportunities
Quality of education and job training
Availability of community resources and opportunities for recreational activities
Transportation options
Public safety

10. Examples of Social Determinants (2)
Social support
Exposure to crime, violence, etc.
Socioeconomic conditions
Residential segregation
Language/literacy
Culture

11. Examples of Physical Determinants
Housing
Schools, worksites
Exposure to toxic substances and other physical hazards
Physical barriers, especially for people with disabilities

12. Economic Stability Poverty Employment Status Access to Employment
Housing stability (homelessness, foreclosure)

13. Education Policies that Support Health Promotion
School Environments that are Safe and Conducive to Learning
High School Graduation Rates
Enrollment in Higher Education

14. Social and Community Context
Family Structure
Social Cohesion
Perceptions of Discrimination and Equity
Civic Participation
Incarceration/Institutionalization

15. Health and Health Care
Access to Health Services: Clinical and preventive care
Access to Primary Care: Community-based health promotion and wellness programs
Health Technology

16. Neighborhood and Built Environment
Quality of Housing
Crime and Violence
Environmental Conditions
Access to Healthy Foods

17. Healthy People 2020 (HP 2020): Background data related to economic stability
In percent of persons were living below the poverty threshold
22 percent of children ages 0 to 17 were living below the poverty threshold in 2010
71 percent of children ages 0 to 17 were living with at least one parent employed full time, year round

18. Healthy People 2020 (HP 2020):Objectives related to economic stability
Increase use of alternative modes of transportation for work
Eliminate very low food insecurity
Reduce past-month use of illicit substances

19. HP 2020:Objectives related to education
Increase the proportion of the population that completes high school education
Reduce the number of new schools sited within 500 ft of an interstate/federal/state highway
Increase the proportion of elementary, middle and senior high schools that require school health education

20. HP 2020:Objectives related to health and health care
Increase the proportion of persons with health insurance
Increase the proportion of persons with a usual primary care provider
Reduce the proportion of persons engaging in binge drinking during the past 30 days

21. HP 2020:Objectives related to neighborhoods and the built environment
Reduce the number of days the air quality index is poor
Reduce hospitalizations for asthma
Increase the proportion of persons served by community water systems who receive water that meets standards of the Safe Drinking Act
Reduce homicides
Reduce physical assaults

22. HP 2020:Objectives related to social and community context
Reduce adolescent and young adult perpetration of, and victimization by, crimes
Increase the proportion of adults with disabilities who report sufficient social and emotional support
Reduce the suicide rate
Reduce the proportion of persons who experience major depressive episodes

28. Place Matters: Life Expectancy by Zip Codes