Authors: Sarah Halpin, Nalani Tarrant, and Yuriko de la Cruz of NACHC’s Social Drivers of Health Team.
Social needs. Social risks. Social barriers. Social determinants of health.
These terms are used interchangeably when it comes to describing the strengths, challenges and barriers related to the health and well-being of our communities. But when it comes to advancing health equity, these terms can be confusing, alienating, and even demeaning.
When addressing policies, systems, and structures that fuel racial inequities in areas that influence a person’s health, such as health care, housing, and access to healthy food and transportation, “social drivers of health” is more accurate. When using the term “determinants” it can have a sense of finality, stripping individuals of their agency to manage their own health and well-being, and minimizing accountability amongst policymakers and those in power for the social and political decisions that create these inequities—as though struggles to access food or housing are predetermined and thus cannot be changed.
Recent research suggests that “drivers” is a more accessible, understandable term that communities prefer. The National PRAPARE® Team is moving forward with adopting the term “social drivers of health” in lieu of “social determinants of health,” as this more accurately describes the ability for policy-makers, communities, and individuals to affect change on the factors negatively impacting health and well-being.
In our work to advance health equity, it is important to use standardized SDOH-related needs data, like the PRAPARE® risk screening tool, to understand the factors that result in poor health outcomes. This data is needed to address immediate needs of individuals and families, which can then be aggregated to understand the harmful impact of policies and systems on the health of a community.
Using the term “social drivers of health” reflects the National PRAPARE® Team’s collective goal of using SDOH-related needs data with community voice to inform upstream efforts related to health equity while allowing health centers to understand and describe their role in advocating for policies to improve health and well-being in their local communities.
Related: In a recent episode of the NACHC podcast, “Health Centers on the Front Lines,” our Senior Vice President of Public Health Priorities, Ben Money, interviewed Dr. John W. Hatch, one of the founders of the health center movement and an early adopter of using the term “social drivers of health.” They discussed the importance of language that speaks to the realities of peoples’ lives rather than using obscure language that blurs our understanding of the factors that drive health. Tune in to hear this important conversation!
Graphic credit: Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved January 18, 2023, from https://health.gov/healthypeople/objectives-and-data/social-determinants-health