Over the past decade the health of Americans has improved in some areas: Life expectancy at birth has increased; rates of death from coronary heart disease and stroke have decreased. Nonetheless, public health challenges remain, and significant health disparities persist.
Healthy People 2020 is a government-sponsored comprehensive program that has set 10-year, national goals and objectives for improving the health of all Americans. One of its four overarching goals is addressing the social determinants of health with its program “Creating social and physical environments that promote good health for all.” This emphasis is shared with 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.
Health starts in our homes, schools, workplaces, neighborhoods, and communities. We know that taking care of ourselves by eating well and staying active, not smoking, getting the recommended immunizations and screening tests, and seeing a doctor when we are sick all influence our health. Our health is also determined, in part, by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships. The conditions in which we live partially explain why some Americans are healthier than others and also, why Americans are not as healthy as they could be.
The Social Determinants of Health focus within Healthy People 2020 is designed to identify ways to create social and physical environments that promote good health for all. The Healthy People 2020 initiative developed a “place-based” organizing framework that reflects five key areas of social determinants of health: economic stability, education, social and community context, health and healthcare, neighborhood and built environment. Advances are needed, not only in health care, but also in fields such as education, childcare, housing, business, law, media, community planning, transportation, and agriculture. Making these advances involves working together to:
- Explore how programs, practices, and policies in these areas affect the health of individuals, families, and communities.
- Establish common goals, complementary roles, and ongoing constructive relationships between the health sector and these areas.
- Maximize opportunities for collaboration among Federal-, state-, and local-level partners related to social determinants of health.