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The Social Determinants of Health Initiative
The Social Determinants of Health Initiative


A 2008 World Health Organization report defines social determinants of health as “the complex, integrated and overlapping social structures and economic systems that are responsible for most health disparities. These social structures include social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world.” Addressing the causes of disparities caused by social determinants and mitigating their effects are essential to the long-term sustainability of our healthcare system, economy, and environment.

In 2012, PSU Schools of Social Work (SSW), Community Health (SCH), and the Department of Sociology, with support from the Provost and Research & Strategic Partnerships, launched the Social Determinants of Health Initiative (SDHI). The goal of the Initiative is to promote community health by identifying, understanding, and addressing the systems and structures that lead to health inequities.

Founded by Drs. Laurie Powers, Carlos Crespo, and Veronica Dujon, the Initiative is an interdisciplinary network for researchers, policy makers, and healthcare practitioners from universities, community groups, health organizations, and government agencies interested in studying the causes of health disparities and finding solutions to them. The SDHI leverages the collective resources and expertise of members of the network. It provides a platform for collaborative research and a home for projects aimed at developing, implementing, and testing the efficacy of programs addressing challenges posed by SDH at the social, environmental, and individual level. The Initiative also provides, information, education, mentoring, and training related to SDH.

The SDHI includes over 150 members affiliated with departments throughout PSU and OHSU, as well as from state and local agencies, community organizations, and local health systems. Nine research centers from PSU, OHSU, and the State have ties to the SDHI. More than 20 related research projects are highlighted on the SDHI website. Dr. Christina Nicolaidis, MD, MPH, directs the Initiative as Professor and Senior Scholar in the Social Determinants of Health in the SSW. As a link between institutions, she also retained research and clinical appointments at OHSU.

“Health isn’t just about biology,” said Dr. Nicolaidis. “We already know there are a multitude of social factors that affect health—socio-economic status, race, ethnicity, disability, violence, discrimination housing… you name it. The trickier question is what to do about it? My hope is that the SDH Initiative can bring together individuals throughout the area so we can start figuring out how to address social inequalities and improve health equity.

Along with Dr. Nicolaidis, PSU hired four new faculty members whose research focuses on SDH: Dr. Ginny Garcia-Alexander in the Dept. of Sociology and in the SCH, Drs. Dawn Richardson, Lynne Messer, and Kelly Gonzales. Together they have over 30 funded or pending projects with sponsors including the EPA, the NIH, the RWJF, the NIMH, the CDC, and others. They also have dozens of publications and presentations that have advanced knowledge in the field.

“When we examine the major health problems we face today: obesity, diabetes, substance abuse, violence, we find these are not health or medical problems per se. They’re community problems, and the solutions to them are based in social determinants of health. If we don’t address them as such, providing healthcare will become unsustainable,” said Dr. Carlos Crespo, Director of SCH.

“One of the major strengths of PSU is its capacity to conduct interdisciplinary research on SDH,” said Dr. Veronica Dujon, Associate Dean, College of Liberal Arts and Sciences. “This and the urban environment we’re located in, our history of community engagement, and partnerships with organizations like OHSU are factors that allow us to successfully pursue this research agenda and stand out nationally and internationally as a hub for research, innovation, and education in the area of SDH.”

“Community Health, Social Work, and the Department of Sociology are dedicated to the same goals,” added Dr. Laurie Powers. “I think the Initiative is really breaking down the walls between our disciplines. When you think of social determinants of health, you think of upstream problems and those suffering their effects downstream. We’re all working to address both sides of the issue. That commonality ideally positions PSU to move forward with this kind of research.”

Finding solutions to the causes of disparities in health and healthcare is essential to developing a sustainable model of society. Issues like race, ethnicity, sexual orientation, and access to resources require attention from the top down. They pose difficult and unique challenges that will require the collaborative efforts of academics, organizations, government, and the public to overcome. Further downstream the effects of disparities become apparent: populations not well-served by providers, distrustful of the healthcare system, or worse.  Helping these groups gain access to healthcare, education, and safe living environments will improve the quality of life for all.

Working with the community and taking on the challenge of identifying, understanding, and addressing the systems and structures underlying health inequities is how the Social Determinants of Health Initiative at PSU is contributing a more sustainable world.

Follow the link for more information about the Social Determinants of Health Initiative. For community stakeholders, practitioners, and researchers interested in SDH, the Institute for Sustainable Solutions is holding a Research into Action Symposium on SDH February 28thFor more information click here.

Authored by Shaun McGillis
Posted January 23, 2014