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(air whooshing)
- Achieving health equity is the situation
where everyone has the opportunity to be
and ideally is as healthy as possible,
regardless of their social or economic circumstances.
Our lives are influenced
by the pillars of the social determinants of health,
economic stability, education access and quality,
healthcare, neighborhood and built environment,
and social and community contexts.
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Social determinants of health influence all
of the infections and conditions
under the purview of this Center.
The majority of health disparities are due
to systemic factors that influence access to
and use of health-related services,
such as laws, policies, and structures
that influence income, education, racism,
homophobia, transphobia, housing,
health insurance, and transportation.
Done well, leveraging social determinants
of health creates long-term change that prevents infections
and brings us closer to public health justice.
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Because positively influencing social determinants
can make large-scale sustainable change
that improves health outcomes, saves lives,
and brings the nation closer to health equity.
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Throughout the Center, people are analyzing data
through the lens of social determinants of health
and supporting programs that work.
Approximately 80% of our budget goes
toward funding entities outside of CDC,
primarily health departments, community organizations,
and educational agencies.
And we fund them to work
with communities disproportionately affected by HIV,
STDs, hepatitis, and tuberculosis.
As part of this work, we support wraparound services
and outreach programs that enable people to get tested,
link to care, avoid infection, and get vaccinated.
With some of our human and financial assets,
we conduct groundbreaking research
and issue guidelines to address barriers
to achieving optimal health.
There is so much more that we do.
Our labs have developed and evaluated diagnostic tools
that can make it easier for people to get tested.
Our epidemiologists analyze data
to understand the underlying causes of disparities.
And we bring essential prevention information to the public,
partners, and key populations.
(air whooshing)
My introduction to the influence of social determinants
of health started with a personal experience.
When I was a medical resident
at San Francisco General Hospital,
I learned how much individual health depends
on a supportive society.
I remember a patient I saw several times
in the emergency department who had diabetes
and a wound infection
that eventually required amputation of his foot.
Diabetes wound infections are hard to treat,
but this man did not lose his foot because of that.
He lost his limb because he was living on the street
with no means of providing himself good wound care.
And that situation was
because the city had expensive housing,
limited mental health services,
and ultimately policies that restricted the concept of care
to medical care rather than a more holistic approach
to public health and well-being.
So much has changed since the 1980s.
We have a cure for hepatitis C,
highly effective HIV treatment,
new regimens for tuberculosis.
Marriage equality is in full force,
and syringe service programs are becoming mainstream.
But we still have major epidemics and massive disparities
that continue to challenge our sense
of whether our country is just.
Any nation's policies and social environment
typically create an inequitable situation
unless we explicitly and thoughtfully work against it,
reminding me that policies that address social determinants
are an underutilized tool in public health.
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