Addressing Social Determinants and Health

Equity Issues in Adolescent Health Practice

Tasha Toby, Senior Analyst, Adolescent Health & Injury Prevention

National Association of County and City Health Officials (NACCHO)

Sharron Corle, Associate Director, Adolescent HealthAssociation of Maternal & Child Health Programs

(AMCHP)

After this session, you will …

Have improved your understanding of social determinants /health equity concepts and their relevance to adolescent health practice

Be able to discuss potential challenges to utilizing a social determinants/health equity approach to adolescent health practice

Be able to describe current efforts to address the impact of social determinants on health

What are some of the reasons why Janie is

in this situation?

What could we have done? And, how can we support Janie and her boyfriend now?

Health Disparities

Various or differences in health among groups of people. Health disparity may refer to any difference in health status – not just differences in the

context of health equity andsocial justice.

Health Inequities

Differences in population

health status and mortality rates that

are systemic, patterned, unfair, unjust, and actionable as opposed

to random or caused by those who become ill.

Definition: Economic and social conditions that influence the health of individuals, communities, and jurisdictions as a whole, such as income, housing, employment, and social services.

Income and Social Status Social Support Networks Education and Literacy Employment/Working

Conditions Social Environments Physical Environments Personal Health Practices and Coping Skills Healthy Child Development Biology and Genetic Endowment Health Services Gender Culture

Definition: Refers to fairness in the Distribution of resources and the

freedom to achieve healthy outcomes

between groups with differing levels of social disadvantage.

** Note: cute graphics borrowed from a presentation by Jane Moore, Ph.D., RD Manager of Oregon Department of Human Services-Health Services

Teen pregnancy can result from many different

situations, a young person MAY get pregnancy

because they: Have limited knowledge about sexuality

and reproduction Prefer abstinence, but feel pressured into

having sex Feel that having a baby at a young age is

normal and desirable

Conversely, a young person may get pregnancy

because they may NOT have: The motivation to delay pregnancy Access to effective birth control The skills to use birth control effectively The confidence and communication

skills to negotiate condom use Power in a relationship to make these

decisions

How well are programs/efforts you’re using right now addressing the multiple factors that may have influenced Janie’s pregnancy or her (or her boyfriend’s) future ability to be successful as a parent?

What are some of the challenges of addressing these issues in your work?

How might you change your programs/efforts to address some of these issues?

BEST: Building Economic Security Today Goal: Reduce disparities and inequities in

health outcomes for families by improving their financial stability

Asset development project– accumulation, leveraging, preservation and creation

Integrated into existing WIC and home visiting programs

Part of health department’s 15-year Life Course Initiative

Children’s Aid Society-Carrera Program

Moving to OpportunityNurse-Family Partnership Program

Teen Outreach Program

Sharron Corle – scorle@amchp.org

Tasha Toby – ttoby@naccho.org