The de Beaumont Foundation Speakers Series highlights leaders in public health practice, advocacy, policymaking, and related fields.

In the wake of the COVID-19 pandemic and the health disparities it has both exposed and intensified, public health agencies like the Centers for Disease Control and Prevention are advancing their efforts around the social determinants of health. Its National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) is seizing this momentum to address chronic disease further upstream.

“It’s really taken COVID to say, we have these unbelievable disparities, and we need to invest in something beyond what we have been doing,” NCCDPHP Director Dr. Karen Hacker, MD, MPH, told de Beaumont staff at a Speaker Series event, making time to virtually join the Foundation while working on COVID response efforts.

With the pandemic forcing public health to consider more innovative approaches to growing disparities, Hacker said, “The big piece now is, can we use that opportunity and come out with a different strategy?”

For NCCDPHP, that has meant creating a framework to guide a targeted approach to the social determinants of health that reflects the role of public health as a convener, integrator, and influencer. The framework is organized around five principles to support communities in their efforts to develop and implement health equity solutions:

  • Building workforce capacity and equitable practices;
  • Identifying and implementing evidence for community-driven practices and measures;
  • Fostering multi-sector, multi-level partnerships and collaboration;
  • Listening, learning, informing, and educating; and
  • Enhancing data and surveillance decision-making capabilities.

“We work to make a vision of healthy people living in healthy communities a reality,” she said. “And now we are really trying to address the social determinants of health so that we can also achieve health equity as a strategic priority.”

As part of its work to promote evidence-based practices and measures, the NCCDPHP has implemented a pilot program for about 20 state, local, territorial, and tribal jurisdictions to create accelerator plans for addressing the social determinants of health across five areas related to chronic disease: the built environment, tobacco policies, clinical care, social connectedness, and food insecurity.

NCCDPHP is also conducting a national evaluation in partnership with the Association of State and Territorial Health Officials and the National Association of County and City Health Officials to evaluate community best practices and evidence-based programs related to the social determinants of health across 42 communities.

Community health workers are another piece essential to the NCCDPHP’s focus on the social determinants of health. The center received a grant through the CARES Act to train and deploy community health workers in COVID response efforts and to reduce health disparities. Through the initiative, community health workers can serve as a bridge between public health and clinical delivery systems, Hacker said.

Such an initiative is especially useful in showing how addressing chronic disease further upstream can minimize the burden on clinical care. Hacker noted that public health faces a challenge in getting the health care field to understand the importance of looking beyond social needs to social determinants, and that doing so can actually lessen clinical costs.

Hacker emphasized that no one sector has the power to fully address the social determinants of health in relation to chronic disease. However, public health can leverage its power as an influencer, convener, and integrator to help other sectors engage in this work. For example, Hacker noted CDC’s unique position as an organization that can effect policy change.

“But in order to do that, we’ve got to be able to bring people together,” she said. Being an influencer “sometimes just means showing up to be able to get other sectors — whether it’s transportation, or education, or economic development — to understand the role that they play in promoting positive health outcomes.”

For more information on the National Center for Chronic Disease Prevention and Health Promotion and its work in health equity and the social determinants of health, visit  https://www.cdc.gov/chronicdisease/index.htm.

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