2016 Presidents Challenge


Triple Aim: Expanding our understanding of what creates health

State health agencies serve a critical role in promoting public health and protecting the health of their citizens by providing access to healthcare services and applying the core public health functions to public health programs and systems (assessment, assurance and policy development). State health agencies are leaders in implementing programs and policies that address health disparities, minority health, and rural populations. The President’s Challenge will empower states to think about the impact Social Determinants (SDOH) have in health outcomes, and more importantly, the role state, local, and national policies play in shaping and addressing those determinants. By expanding our understanding of what creates health, we can begin to develop and implement innovative policies that address key determinants of health inequities.

Examples of actions that could advance this objective:

  • Develop educational materials for cross-sector partners about public health
  • Expand the indicators included in your Statewide Health Assessment
  • Include new partners when developing your Statewide Health Improvement Plan

ASTHO Resources

Achieving Optimal Health for All
ASTHO Policy Statement.

Health Impact Assessments
A health impact assessment is a means for leaders to make informed decisions by identifying the health consequences of their actions.

Additional Resources

Guides and General Resources

CDC Health Disparities and Inequalities Report
CDC’s 2011 Health Disparities and Inequalities Report (MMWR, vol 60 supplement).

WHO: The Determinants of Health
Resource from the World Health Organization detailing various determinants of health and separating them into different categories such as transportation, food, and housing.

HealthyPeople.gov: Determinants of Health
Addresses the determinants of health using social approaches, detailing policymaking and biology/genetics among others.

Social Determinants of Health: FAQ
Gide by CDC listing frequently asked questions about social determinants.

What Drives Health: RWJ Foundation
An in-depth look at how social factors play into the health of populations; specifically social factors including: education, work, and housing.

NAACHO’s Roots of Health Inequity Learning Collaborative
The Roots of Health Inequity: A Web-Based Course for the Public Health Workforce offers health department staff a place to investigate the relationship between social injustice—the fundamental cause of health inequities—and everyday public health practice.

The Relative Contribution of Multiple Determinants to Health
A brief that helps to provide an analysis that demonstrates the value of investments in nonclinical primary prevention and their impact on healthcare costs.

World Conference on Social Determinants of Health
Proceedings of WHO’s 2011 Conference on the Social Determinants of Health.

Beyond Health Care: the Role of Social Determinants in Promoting Health and Health Equity
Issue brief from the Kaiser Family Foundation.

The Social Context of Health Behaviors
Slides from a 2011 NICHD Workshop on Health Behaviors.

Case Studies

What Can Public Health Programs Do to Improve Health Equity?
A perspective from the Association of Schools and Programs of Public Health’s periodical Public Health Reports, 2013 Supplement, Volume 128. Provides an overview to what health inequity is on a global scale, then details how and what type of programs can improve health equity.

Addressing social determinants of health through a school health program
Examples of ways in which to use school health programs to address otherwise unmitigated social determinants of health in school children.

State Strategies to Improve Health through Housing Services
Chart of state attempts to connect health and housing resources, with links to those projects.

Intergenerational Poverty Initiative
Resources from Utah, including the most recent Intergenerational poverty report.

Minnesota Pollution Control Agency commissioner announces creation of environmental justice advisory group
Example of Minnesota’s implementation of environmental justice efforts to address those determinants of health.

Advancing Health Equity in Minnesota
An in-depth report of the work that Minnesota is doing to address health equity as well providing room for increased focus.


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