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I agree with Layla, as well as measuring the distinction between health outcomes related to individual/group behavioral risks and economic and social conditions. Teasing these apart can be methodologically challenging, but possible

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The social determinants of health can vary and interact across many levels, individual, interpersonal, institutional, policy, and structural factors in various ways. I think one of the limitations is that when we are creating interventions to address social determinants of health, conditions that people can control individually and internally, versus those that are more extrinsic and structural, must be taken into account in terms of progress and health change outcomes. while this theory focuses on the economic and social conditions, such as distribution of income, wealth, influence, education, power, as they influence individual and group health, I think the health behaviors of individuals related to behavioral risk factors are important to consider.

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I would enhance this framework by coupling it with resources and knowledge based programs/interventions so that people in the community would be able to understand how their environment plays a role in their well-being and what they can do in order to change the trajectory of that narrative.

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Social Determinants of Health Framework can be helpful for community health promotion theory and practice by identifying promising approaches and evidence-based models to help rural organization address SDOH to improve quality of life.

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Social Determinants of Health impact health and well being.

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Lack of standardization in what variables define the social determinants of health and the appropriate screening tools to track these variables. Inconsistent data and measurement. Inadequate healthcare-based solutions for the core problems such as access to care, poverty and food insecurity

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An understanding of social factors provides invaluable insight into improving a patient's health status for predicting negative outcomes. Instances such as high-risk pregnancies, early hospital readmissions, poor compliance with prescribed medications, and susceptibility to chronic disease

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Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

SDOH can be grouped into 5 domains:
1. Economic stability
2. Education Access and Quality
3. Health care access and quality
4. Neighborhood and build enviorment
5. Social and community context

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There are different categories of SDOH according to different organizations & agencies

According to WHO, SDOH is the “Conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems.”

· Structural determinants (such as socio-economics status & community)

· Intermediate determinants (the conditions in which people live and work)

According to Healthy People: SDOH is the “Conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks.” It is divided into five domains

Economic stability (employment & work environment, food security, safe & affordable housing, and income)

Education (language development & literacy but differs in urban & rural areas)

Social and community context (civic participation: relationships formed & voting)

Health and healthcare access (Health literacy, health insurance coverage)

The neighborhood and built environment (Access to stores that sell healthy foods, Sidewalks)

The ecological model perspective “acknowledge the interaction of several levels of individual, interpersonal, institutional, policy, and structural factors that affect health and well-being”

· Individual

· Interpersonal

· Institutional

· Policy

· Structural factors

Rural Community Health & Well-Being Framework:  identified 3 major drivers of health, then added others. Robert Wood Foundation states that “Good health begins in the places where we live, learn, work and play.

Economics, Environment, Social supports, Health, Safety and security, Education, Community infrastructure, Recreation/heritage, and arts, Community processes

and Population

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SDOH helps to identify needs specific to a community and tailor programs that address such unique needs.

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The limitations of SDOH particular to Rural communities are

· Limited resource availability & limited capacity for program implementation

· Cultural (the social norm in making healthy choices)

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What are limitations of SDOH? How would you improve this framework?

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What are limitations of SDOH? How would you improve this framework?

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How is a SDOH framework helpful for community health promotion theory and practice?

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How is a SDOH framework helpful for community health promotion theory and practice?

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What are categories/domains of social determinants of health? What are examples of SDOH?

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What are categories/domains of social determinants of health? What are examples of SDOH?