Reply to Community Health 1

Since the 1980s, there has been a growing call for nations across the globe to address health inequities, which are systematic, unfair, and avoidable differences in health outcomes and their determinants between segments of the population, such as by socioeconomic status (SES), demographics, or geography.   Social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.

Although much is understood about the role of social determinants of health in shaping the health of populations, there is still much to learn and implement about how to measure health disparities, health inequities, and social determinants of health at the national level, and the challenges of health equity persist. An overarching public health goal of the United States is to eliminate disparities in health and health care to improve the overall health of the nation and achieve health equity (Healthy People 2020). Healthy People 2020 includes social determinants of health as one of its 12 leading health indicator topics and one of its 42 topic areas, reflecting the importance of conditions of living for health.

Accurate and timely assessment and monitoring of the magnitude and direction of change of health disparities and their determinants are necessary for public health evaluation of progress toward the US goals. Measuring differences in health and its determinants (including social determinants) that are associated with social position and assessing change over time is a prerequisite for timely assessment of the effects of policies on the health of different segments of the population. 

It is critical that professional health educators, in collaboration with health care and other sectors, continue to advance understanding of social determinants of health and the pathways through which they operate on specific health outcomes.

Penman-Aguilar, A., Talih, M., Huang, D., Moonesinghe, R., Bouye, K., & Beckles, G. (2016). Measurement of Health Disparities, Health Inequities, and Social Determinants of Health to Support the Advancement of Health Equity. Journal of public health management and practice : JPHMP, 22 Suppl 1(Suppl 1), S33–S42. doi:10.1097/PHH.0000000000000373

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