Social Determinants of Health

Everyone deserves the opportunity to live a full and healthy life. Social determinants of health (SDOH) are the community conditions and neighborhood environments in which we are born, grow, live, work, and age. These are sometimes referred to as upstream factors. SDOH have a major impact on people’s health, well-being, and quality of life.

Community conditions that support the health and wellbeing of residents include:

Available employment and an adequate tax base that can support high-quality schools.
Affordable and safe housing where residents are not exposed to overcrowding, allergens, or other hazards.
Healthy food options that supports the nutrition needs of community members.
Safe walking and biking, parks, and trails that support physical activity.
Adequate public transportation to help ensure that residents can access healthcare, jobs, child care, and social services.
Social cohesion and connections with neighbors that improve wellbeing.

Simply promoting healthy choices isn’t enough. Public health agencies and their partners need to take action to improve the conditions in people's environments.

How OHPP addresses SDOH

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Taking an equity approach

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How SDOH connect to health outcomes

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Additional SDOH resources

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How OHPP addresses SDOH

Successfully addressing SDOH requires cross sector collaboration. This includes bringing together resources to work together on shared goals with shared outcomes. OHPP works with a variety of stakeholders including local health departments, healthcare systems, community based organizations, schools, worksites, and others.

The Earned Income Tax Credit (EITC) is a tax credit provided to individuals and families with low- to moderate-incomes. The amount of a tax credit is determined mostly by income level, marital status, number of dependent children, and disability status. Because people of color, women, and immigrants are overrepresented in low-wage work, state EITCs are an important tool for advancing equity. EITCs bolster families’ incomes and boost local communities and state economies.

The Utah State Legislature enacted a state non-refundable EITC starting in 2022. Individuals and families who qualify in Utah can now access both the federal and state EITC. The Utah state EITC is a non-refundable tax credit worth 15% of the federal EITC. Utahns who qualify must file taxes to access the benefits of both the federal and state EITC. OHPP programs have worked together to create and distribute materials educating priority populations about EITC.

OHPP programs increase food security by supporting Double Up Food Bucks (DUFB) and Utah Produce Rx. Produce Rx is a fruit and vegetable voucher program that is implemented in a healthcare setting. Healthcare providers screen patients in their clinics and enroll eligible patients into the program. Participants are given up to ten, $20 vouchers to spend on fruits and vegetables at participating redemption locations. The DUFB program provides SNAP participants with $30 to spend on fresh fruits and vegetables at participating farmers markets. This program benefits low-income families by providing access to healthy food and supports local farmers.

Throughout 2023, OHPP worked with the United Way of Salt Lake to create a leadership team to address SDOH at the individual, community, and systems level in South Salt Lake. The leadership team developed a multisector action plan to address SDOH and accelerate action in South Salt Lake that will lead to improved chronic disease outcomes among persons experiencing health disparities and inequities.

Taking an equity approach

OHPP is committed to ensuring that all Utahns have fair and equitable opportunities to live safe and healthy lives. Data consistently show racial disparities across numerous health outcomes and disproportionate disease risk among people of color. Many of these outcomes are caused by systematic marginalization and social inequities. OHPP is committed to advocating for, supporting, and serving all individuals and communities in Utah.

In 2021, OHPP pledged to advance racial equity in our programs by committing to the National Association of Chronic Disease Director’s President’s Challenge. As a result, we have engaged in various efforts to increase staff knowledge about racial equity and its connection to health outcomes, examine racial inequities through a social determinants of health lens, and assess policies and procedures using a racial equity framework. We have also established the OHPP Health Equity Council.

As an Office, we believe:

Dismantling racism is a public health imperative. Structural racism impacts health, education, employment, and economic opportunities. Meaningful change requires addressing racial and social inequities.
Many poor health outcomes are a direct result of historical and current policy decisions.
We must prioritize ending systemic barriers and advancing policies and programs that create equitable opportunity for health and well-being.
Public health institutions have a key role to play in dismantling systems of oppression.
Public health has a responsibility to create conditions that allow all members of our communities to make healthy choices.
All Utahns are negatively impacted by inequitable policies.

How SDOH connect to health outcomes

SDOH are the community conditions and neighborhood environments in which we are born, grow, live, work, and age. These factors have been shown to have a greater influence on health than genetic factors or access to healthcare services. See how the different SDOH domains connect to health outcomes.

Economic opportunity is one the most powerful predictors of good health. When families are in poverty, they often do not have reliable access to the goods and services that are necessary for a healthy life. They may also face trauma and chronic stressors such as violence and insecure housing, employment, and food. When families face economic challenges, adults often work long hours or multiple jobs, making it more difficult to engage with their communities, cook healthy meals, spend time with family and friends, go to medical appointments, and participate in physical activity and other healthy activities.

When housing cost burdens are high, individuals and families may experience unhealthy and poor-quality housing, overcrowded housing, and limited use of utilities. Poor quality and unstable housing exposes residents to toxins, mold, pests, and conditions that can trigger asthma and increase risks of injuries.

Safe places to walk and bike and access to parks can encourage health promoting activities such as increased physical activity and community connections, as well as reduce poor mental and physical health outcomes, while supporting community resilience to climate change and pollution. Exposure to poor air quality can increase the risk of cardiovascular disease, respiratory conditions, and mortality.

Safe, adequate, and accessible transportation options have been linked to improved physical and mental health, physical activity, employment outcomes, access to medical care, and resiliency during disasters. For households and individuals without access to a car, including many low-income individuals and people of color, public transportation, active transportation, and shared mobility options can be critical links to jobs and other destinations that provide essential goods and services.

Education contributes to health in many ways. In early childhood, education is important for healthy development, and has been associated with lifelong educational, economic, and health benefits. Early childhood is a crucial period for brain development, shaping nearly every aspect of an individual’s future health and wellbeing. School-based learning contributes to the knowledge and cognitive skills necessary to make healthy choices as well as important social and physiological skills including problem solving, teamwork, self-control, and social support. Individuals who graduate high school are more likely to find quality jobs with living wages and decent working conditions.