Health Manager Orientation Guide

Understanding Social Determinants of Health and Health Equity

A man holding a young boy's hand as they walk in the park.Head Start programs are committed to giving everyone the opportunity to improve health and health care outcomes. Through prevention, promotion, early identification. and intervention, health services staff are a bridge connecting families and staff to the resources and supports needed to navigate and eliminate the many barriers and challenges they experience and change their health trajectory. Keeping health equity at the center of this work ensures children enter school healthy and ready to succeed.

Head Start health managers have an opportunity to reduce the impact of these risk factors, strengthen protective factors, and decrease health disparities, which are the differences in health and health care between groups of people. Health managers who understand how risk and protective factors influence health outcomes can develop policies and practices to minimize risk factors and promote protective factors.

Social determinants of health (SDOH) provide a framework for understanding the many conditions that put individuals at greater risk of negative health outcomes. SDOH are the conditions in the environments where people are born, live, learn, work, play, worship, and age. SDOH affect a wide range of health, functioning, and quality-of-life outcomes and risks. While Head Start children, families, and staff may be experiencing risk factors associated with negative health outcomes, the comprehensive services provided in Head Start programs and the support of family and community can be important sources of protective factors. Protective factors lower the likelihood of negative outcomes or reduce a risk factor’s impact.

Social determinants of health are grouped into five domains:

  • Economic Stability
  • Education Access and Quality
  • Health Care Access and Quality
  • Neighborhood and Built Environment
  • Social and Community Context

The SDOH have a disproportionately negative impact on the health of people from marginalized communities such as Black, Indigenous, Latino, and other communities of color; people with disabilities; LGBTQIA+ people; and people who live in under-resourced neighborhoods. For marginalized communities, structural and systemic racism and other forms of oppression are operating among each of these domains.

8 children of various ages and ethnicities holding hands as they stand side by side outdoors while the sun shines brightly behind them.Understanding the SDOH present in communities and the impact on children, families, and staff in Head Start programs is essential to designing services that help families overcome these barriers and improve health outcomes. Addressing SDOH is a key indicator in a program’s journey toward improving health equity. Health managers and program leadership should take the time to understand and use SDOH to design effective strategies to support diverse families, so children can enter school healthy and ready to learn.

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