Online Program

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

Tuesday, November 5, 2013 : 1:32 p.m. - 1:50 p.m.

Brad Jacobson, MPH, San Mateo County Health System, San Mateo, CA
Matt Beyers, MA, MSCRP, Alameda County Public Health Department, Oakland, CA
Amy Smith, MPH, Bay Area Regional Health Inequities Initiative (BARHII), Oakland, CA
Neil Maizlish, PhD, MPH, Center for Chronic Disease Prevention and Health Promotion, California Department of Public Health, Richmond, CA
Pamela Stoddard, PhD, Public Health Department, Santa Clara County, San Jose, CA
Abigail Kroch, PhD, MPH, Dept of Public Health, Contra Costa Health Services, Martinez, CA
Jennifer Henn, PhD, Napa County Public Health
Randy Reiter, PhD, MPH, San Francisco Department of Public Health, San Francisco, CA
Sandi Galvez, MSW, Bay Area Regional Health Inequities Initiative, Oakland, CA
Rochelle Ereman, MS, MPH, Division of Public Health, County of Marin Department of Health and Human Services, San Rafael, CA
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.

Learning Areas:

Other professions or practice related to public health
Program planning
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Analyze common social determinant of health (SDOH) data to identify places and populations requiring local public health interventions to improve health equity. Frame analysis of the American Community Survey (ACS) and the California health interview survey (CHIS) to best show SDOH inequities, using examples of food insecurity from CHIS and educational attainment from the ACS. Respond to frequently asked questions related to local public health SDOH indicator data analysis and usage. Define the roles for public health in responding to the influences of physical, economic, and social environments by linking SDOH indicators to the 10 essential public health services. Improve local public health epidemiologist competency by showing how to analyze, discuss, and apply SDOH data to public health practice.

Keyword(s): Social Inequalities, Indicators

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Brad Jacobson holds a Masters in Public Health and is an epidemiologist with the San Mateo County Health Department in California. He serves as Co-chair of the Data Committee and is on the Executive Committee of the Bay Area Regional Health Inequities Initiative, a cooperative of 11 Bay Area county and city health departments. Subject areas of expertise in epidemiology include communicable diseases, tobacco, sexually transmitted diseases, violence, public health surveys, and geospatial analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.