Applying social determinant of health indicators in local health department efforts to address health inequities

Analysis and framing of social determinants of health (SDOH) indicators and their relationship to disparate health outcomes is critical to a local health department's (LHD) ability to address health disparities. The Data Committee of the Bay Area Regional Health Inequities Initiative (BARHII), a collaborative of 11 San Francisco Bay Area county and city health departments, has developed a guide for epidemiologists on how to collect, analyze, and apply a list of prioritized SDOH indicators for use in public health activities that address health inequities. In addition to methodological recommendations, the guide helps link SDOH data to health outcomes and to the 10 essential public health services through which LHDs have the experience, credibility and mandate to address health inequities. The presentation will review a set of indicators and methodologies (e.g. natural breaks, quantiles, ratios), and show high school education and food insecurity as detailed examples. In the Bay Area, the ratio of the proportion of adults over 25 years with a high school education or greater is 2.9 times higher in the best performing census tracts compared to the lowest performing tracts. In addition, in the Bay Area, 53% of low income Latino adults experienced food insecurity in the past year compared to only 28% of low income White adults. Differences in both of these measures are also linked to variations in health outcomes, including mortality. Concrete examples of LHD collaborative, programmatic, and policy strategies to address these SDOH inequities will also be presented.