Editor's note: In The WellNest Watch, master's degree candidates in the public health program at Eastern Michigan University's School of Health Promotion and Human Performance explore news, research and standard practices in the field of health and wellness.
Nathaniel King is a graduate hall director in the Department of Residential Life.
A common assumption surrounding our health is that personal everyday decisions, such as what we eat, where we eat, our activity levels that day, and other similar factors are all that make up our health. Moving from a personal focus to a community-centered approach fills in the gaps that explain our health behaviors. Personal factors do impact our overall health, but let's look at what drives us to make these decisions in the first place.
The Social Determinants of Health are the outside conditions that influence an individual's health. The SDOH are categorized into five domains: economic stability; education access and quality; healthcare access and quality; neighborhood and your built environment; and social and community context. Let's explore these domains and understand the effect they have on our overall health.
The SDOH connect your everyday lived experiences and address how these factors affect your health in a variety of ways. Your economic stability is directly tied to your income level, as well as the employment opportunities in your area. Education access and opportunity are directly tied to your literacy level, as well as access to academic materials in and outside of the classroom. Your education and access to higher education impact your job opportunities, income level and career stability. Healthcare access is not just your access to healthcare but also your understanding of the healthcare system. Your ability to seek and access primary care, understand insurance requirements and how to use insurance, and your ability to get medication are part of healthcare access and quality. Your neighborhood and built environment is where you live. Are there safe areas to spend time outside, sidewalks to get daily exercise in, local gyms, playgrounds, clean air, clean water to drink, and low exposures to toxic materials? All of these factors determine how people live in their communities and the everyday decisions that they make. The last domain is social and community context. This domain focuses on your social support and safety. It addresses how safe you feel in your community, how connected you feel to others, and the services offered in your community. These domains have a huge role in shaping your overall health and access to resources to better your health and the ability to make more informed health decisions.
The SDOH highlight the inequalities that show up in communities and show how these outside influences impact our health. For example, an individual who lives in a food desert (an area that lacks access to fresh and affordable food, most often reliant on corner stores and fast food restaurants) may eat more processed foods. From the outside perspective, we often hear that we should eat a more nutritious diet, more fruit, and less red meat. Using the SDOH, we can see that this person lacks access to these foods to make diet changes.
Issues such as those above are often multi-faceted and more complex than making a simple change. Food deserts are not often a standalone issue in a community. Food deserts are often found in rural areas and neighborhoods of lower socioeconomic status. Residents in these areas may face transportation access issues due to income, public transportation limitations, a lack of time to cook due to work, a lack of nutrition knowledge due to gaps in education funding, housing instability, low levels of social support, and a lack of resources needed to cook a healthier meal. Looking at this, we are able to see how complex eating better can be. This example can be applied to many other health factors, such as housing access, furthering your education, increasing your health literacy, and getting daily exercise.
Health is often more complex than personal actions. The SDOH allows public health professionals to see the gaps in community services and areas to create more equitable communities. Addressing these issues is key to reducing negative health outcomes. This allows public health professionals to advocate for equity and have an equity-centered approach to health. Strengthening community support creates more equitable communities that are more sustainable for providing residents with the resources and knowledge they need to have better health outcomes. Health behavior is not a personal decision but a wider decision impacted by your ability to access resources needed to make these decisions. This approach to health allows us as professionals and community members to strengthen these dimensions and remove barriers to achieving better health.
Contributors to The WellNest Watch health column are Kegan Tulloch and Ebrima Jobarteh, graduate assistants in the Office of Health Promotions, and Shafaat Ali Choyon and Nathaniel King, graduate hall directors in the Department of Residential Life. All four are master's degree candidates in the Public Health Program from the School of Public Health Promotion and Human Performance at Eastern Michigan University.
