Ten Essential Public Health Services and How They Can Include Addressing Social Determinants of Health Inequities

Public health departments and their partners need to consider how conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. These social determinants of health (SDOH), and actions to address the resulting health inequities, can be incorporated throughout all aspects of public health work. Through broader awareness of how the key public health practices can better incorporate consideration of SDOH, public health practitioners can transform and strengthen their capacity and impact to advance health equity.

Five Key Areas of SDOH (HP 2020)

Monitor health status to identify and solve community health problems


Include SDOH measures as basis for addressing community health problems and inequities

Ensure community health assessments (CHA) include SDOH measures and engage communities and multi-sectoral partners in CHA efforts.

Diagnose and investigate health problems

and health hazards in the community


Include community-level determinants of health in investigations, as well as policies and practices that involve other sectors to support them.


For example:

  • Ensure water sources meet required standards

  • Ensure brownfield sites Identify hazardous waste that might contaminate a community

  • Address deteriorating housing conditions to prevent lead poisoning and other hazards to health.

 Inform, educate, and empower people about health issues 


Ensure outreach and education efforts address social and structural determinants of health inequities


Ensure access to culturally and linguistically appropriate approaches to community health (e.g. both of which can decrease likelihood of seeking needed health care.., REACH) to help address SDOH. Approaches should take into account such challenges as structural racism and stigma against immigrants, both of which can decrease likelihood of seeking needed health care.

Mobilize community partnerships and action

to identify and solve health problems


Engage and collaborate with community members and non-traditional partners associated with SDOHs, such as


Develop policies and plans that support

individual and community health efforts


Leverage evidence-based policies in non-health sectors that affect SDOH and health outcomes, such as


  • Safe and affordable housing that can reduce risk for asthma, lead poisoning, homelessness

  • Full-day kindergarten that can reduce adverse health prospects such as teenage pregnancy

  • Develop and implement state/community health improvement plans that include and address the SDOH in collaboration with community partners


Upstream Factors Determine Health Outcomes

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