This document discusses health equity, health disparities, and social determinants of health. It defines health equity as achieving the highest level of health for all people through addressing avoidable inequalities. Health disparities are closely linked to social and economic disadvantage and adversely affect groups that have systematically faced discrimination. Social determinants of health are the circumstances where people are born, live, work and age, shaped by economics, social policies and politics. These determinants include education, employment, income, housing, transportation, social status and environment. The document provides examples of health disparities data from different cities and states, and discusses how improving social determinants like education can positively impact health.

1. Ned
Calonge,
MD,
MPH
President
and
CEO
Surveillance for health disparities and the
social determinants of health:
data and health equity

2. Key terms
§ Health equity
§ Health disparities
§ Social determinants of health

3. Health equity
§ Attainment of the highest level of health for all people
§ Achieving health equity requires valuing everyone
equally with focused and ongoing societal efforts to
address avoidable inequalities, historical and
contemporary injustices, and the elimination of health
and health care disparities
Healthy People 2020

4. Health disparities
§ A particular type of health difference that is closely linked with
social, economic, and/or environmental disadvantage
§ Health disparities adversely affect groups of people who
have systematically experienced greater obstacles to health
based on:
• racial or ethnic group
• religion
• socioeconomic status
• gender
• age
• mental health
• cognitive, sensory, or physical disability
• sexual orientation or gender identity
• geographic location
• other characteristics historically linked to discrimination or exclusion
Healthy People 2020

10. Other health disparities
§ Perinatal and infant
mortality
§ Child and adult obesity
§ Child oral health
§ Teen fertility
§ Diabetes mortality
§ Liver disease mortality
§ Motor vehicle injury
fatality
§ Homicide mortality
§ Mental health
§ Low birth weight
§ Suicide
§ Cervical cancer incidence
and mortality
§ Lung cancer incidence
and mortality
§ Prostate cancer mortality
§ Diabetes incidence and
mortality

11. Social determinants of health
§ The social determinants of health are the
circumstances in which people are born, grow up,
live, work and age, and the systems put in place to
deal with illness
§ These circumstances are in turn shaped by a wider
set of forces: economics, social policies, and politics
World Health Organization Commission on the Social Determinants of Health (2008)

12. Social determinants of health
§ Think in terms of opportunities and barriers:
• Early childhood development, schools, education, literacy
• Economy, jobs, employment, occupation, working
conditions, income, wealth
• Housing, transportation, public safety, parks and
recreation, healthy food access
• Social status, culture, social network, political clout, justice
• Environment, pollution, hazards

13. From: Bay Area
Regional
Health
Inequities
Initiative

14. Washington D.C.:
Short Distances to
Large Disparities in
Health

15. Potential health impact of
improving education

20. Education demographics
(Denver)

21. Poverty demographics
(Denver)

22. Denver life expectancy

23. Colorado population by race/
ethnicity 2010
Source: Colorado State Demography Office.

24. Changing demographics

25. Colorado

28. The Colorado Trust
Theory of Change

29. Theory of Change
Upstream impact Downstream impact
Advocacy
and Policy
Community
Partnerships
Data and Information

30. Intersection of health, place and equity
EquityEnvironment
Health
Access to
Healthy
Food
Schools/
Child care
Health
facilities
Community
Safety/ violence
Transportation
Traffic patterns
Work environments
Housing
Parks/Open
Space playgrounds
30
Brian Smedley, Joint Center for Political and Economic Studies