This paper examines health promotion strategies for a middle-class family through the lens of social determinants of health (SDOH), including race, class, religion, and attitudes toward healthcare. It discusses how income, education, housing, and food access contribute to health disparities, and highlights the CDC's Healthy Communities Program as an example of community-level intervention. The paper recommends age-appropriate screenings for each family member and proposes the ecological model as a guiding framework. By addressing individual behaviors, environmental factors, and community-level policy advocacy, the ecological model offers a comprehensive approach to improving and sustaining long-term family health outcomes.
The Z family's social determinants of health (SDOH) include their race, class, religion, and overall health status. The family is white, middle class, and has good health overall. Their diet is healthy, but the parents do not get enough exercise. The father has prostate issues but does not want to see a doctor. The family entrusts health matters largely to God through prayer, and relies on their own judgment when making health decisions. They hold a general distrust of the healthcare establishment, viewing the industry as beholden to corporate interests that prioritize profits over people. These factors all contribute to the family's health status.
The impact of these SDOH relates to the conditions in which people are born, grow, work, live, and age, as well as the wider set of forces and systems shaping the conditions of daily life (Johnson, 2020). These forces and systems include features of the physical environment, economic and social policies, and social norms and attitudes (Crear-Perry et al., 2021). The term social determinants of health describes the complex interplay between these factors that give rise to health disparities within and between populations.
There is growing recognition of the importance of SDOH in shaping population health patterns. In the United States, differences in income, education, employment, housing, food insecurity, neighborhood safety, and access to transportation have all been shown to contribute to health disparities. Addressing these social determinants is essential to achieving equitable health outcomes. Increasingly, evidence suggests that interventions aimed at improving SDOH can have a positive impact on health outcomes (Crear-Perry et al., 2021). For example, studies have shown that increasing access to affordable housing can lead to reductions in hospitalizations and emergency department visits among low-income families (Johnson, 2020). Similarly, increasing access to nutritious food can improve diet-related chronic diseases such as obesity and diabetes. Programs that provide job training and support have also been shown to improve mental health outcomes and reduce the risk of substance abuse.
As regards the Z family, the family benefits from access to care by living in a middle-class community; however, the family does not much trust healthcare, so there is a need for a health literacy intervention to help them recognize the importance of care — particularly for the parents regarding exercise, and especially for the father due to his prostate issue.
The CDC's Healthy Communities Program recognized the importance of addressing SDOH in its prevention efforts, working with communities across the United States to identify and address factors that contribute to poor health. However, it is no longer funded (CDC, 2022). Through this program, the CDC provided technical assistance, tools, and resources to help communities take action on SDOH. By working together to address these social drivers of health disparities, communities can build healthier environments for all — but programs like this one require continuous support.
"Recommended screenings by family member age"
"Rationale for selecting the ecological model"
"Multi-level ecological model application strategy"
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