From Theory to Action: Applying Social Determinants of Health to Public Health Practice

Dean, Hazel D.; Williams, Kim; Fenton, Kevin

doi:10.1177/00333549131286s301

Cited by 58 publications

(51 citation statements)

References 21 publications

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“…This will be important to adequately understand how socioecological contexts and cultural processes impact health outcomes to guide implementation strategies with increased focus on achieving health equity without unnecessary delay. A fuller appreciation of cultural and socioecological contexts has significant implications for population research for informing health outcomes assessments, intervention studies, and implementation and dissemination science (Dean et al, 2013; Marmot et al, 2008). This is yet another important area that requires greater attention in behavioral medicine.…”

Section: The Connect Frameworkmentioning

confidence: 99%

The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity

et al. 2016

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Health disparities persist despite ongoing efforts. Given the United States’ rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the Con-NECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT’s five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

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Section: The Connect Frameworkmentioning

confidence: 99%

The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity

et al. 2016

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“…The past fifteen years have witnessed increasing recognition by public health stakeholders that social and structural factors are key drivers of pervasive health inequalities, with poverty, social exclusion, stress, unemployment, and inadequate living conditions contributing to elevated disease burden among vulnerable populations (1-3). One aspect of the movement toward a social ecological understanding of health has been a growing interest in neighborhood effects on illness and disease, with recognition that neighborhoods exert substantial influence on individuals’ psychological well-being and physical health (4).…”

mentioning

confidence: 99%

Environmental Influences on HIV Medication Adherence: The Role of Neighborhood Disorder

et al. 2015

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Objectives Neighborhood factors have been associated with increased HIV risk behaviors and elevated AIDS-related mortality, yet prior research has not examined the impact of neighborhood disorder on behavioral disease management among HIV-positive individuals. We hypothesized that highly disordered neighborhoods would expose residents to environmental pressures leading to reduced antiretroviral (ARV) medication adherence. Methods Using targeted sampling, the study enrolled 503 socioeconomically disadvantaged HIV-positive substance users in urban South Florida. Participants completed a one-time standardized interview, which took approximately one hour. We tested a multiple mediation model to examine the direct and indirect effects of neighborhood disorder on diversion-related non-adherence to ARVs; risky social networks and housing instability were examined as mediators of the disordered neighborhood environment. Results The total indirect effect in the model was statistically significant (p=.001), and the proportion of the total effect mediated was 53 percent. The model indicated substantial influence of neighborhood disorder on non-adherence to ARVs, operating through recent homelessness and diverter network size. Conclusions Long-term improvements in diversion-related ARV adherence will require initiatives to reduce demand for illicit ARVs, as well as measures to reduce patient vulnerability to diversion, including increased resources for accessible housing, intensive treatment, and support services.

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“…The HiAP approach refers to the involvement and support of all levels of government with strong leadership at the highest levels (44). Increasingly, there are examples of best practices, even within a communicable disease context, on how to create structural change through establishing policy goals, building capacity, fostering multi-level partnerships across sectors and holding leadership accountable for real change (45).…”

Section: Public Health and Policy Approaches To Syndemics In Indigenomentioning

confidence: 99%

Outbreaks in the age of syndemics: New insights for improving Indigenous health

Andermann¹

2017

Canada Communicable Disease Report

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Conventional approaches for the prevention and control of communicable diseases within Indigenous contexts may benefit from new insights arising from the growing interest in syndemics. Syndemics is a term used to describe a conceptual framework for understanding diseases or health conditions, and how these are exacerbated by the social, economic, environmental and political milieu in which a population is immersed. The use of conventional approaches for outbreak prevention and control remains the bedrock of intervention in the field of communicable diseases; yet on their own, these strategies are not always successful, especially within contexts of marginalization and disadvantage. A broader approach is needed; one that examines the systemic factors involved, understands how various policies and systems support or hinder effective responses and identifies the structural changes needed to create more supportive environments and increase the resilience of the population. In an Indigenous context, whether the focus is on hepatitis C, tuberculosis, HIV or water-borne diseases, it is important to recognize that a) social determinants contribute to the emergence and persistence of outbreaks, b) conventional approaches to communicable disease control are necessary but not sufficient, and c) using a "syndemics lens" can leverage action at multiple levels to tackle the root causes of poor health and inform more effective strategies for improving Indigenous health and reducing health inequities.

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From Theory to Action: Applying Social Determinants of Health to Public Health Practice

Cited by 58 publications

References 21 publications

The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity

The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity

Environmental Influences on HIV Medication Adherence: The Role of Neighborhood Disorder

Outbreaks in the age of syndemics: New insights for improving Indigenous health

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