 Know the definition of social determinants
 Understand the importance of why social
determinants affect the work we do
 Become aware of efforts in the state that
address social determinants and HIV

World Health Organization

 The economic and social conditions that shape
the health of individuals, communities, and
jurisdictions as a whole.
 Social determinants take into account the
conditions in which people are born, grow, live,
work and age. These circumstances are shaped
by the distribution of money, power and
resources at a global, national and local levels.

 Income/Social Status  Early Life
 Education
 Social Support Networks  Employment/Work
 Education/Literacy Conditions
 Social Environment  Food Security
 Gender
 Physical Environment  Health Care Services
 Life/Coping Skills  Housing
 Income and its
 Personal Health Practices Distribution
 Child Development  Social Safety Net
 Social Exclusion
 Gender  Unemployment/
 Culture Employment Security
From World Health From Social Determinants of
Organization Health National Conference

 1. Don't smoke. If you can, stop. If you  1. Don't be poor. If you can, stop. If you
can't, cut down. can't, try not to be poor for long.
 2. Follow a balanced diet with plenty of  2. Don't have poor parents.
fruit and vegetables.  3. Own a car.
 3. Keep physically active.  4. Don't work in a stressful, low-paid
 4. Manage stress by, for example, talking manual job.
things through and making time to relax.
 5. Don't live in damp, low-quality housing.
 5. If you drink alcohol, do so in
 6. Be able to afford to go on a foreign
moderation.
holiday and sunbathe.
 6. Cover up in the sun, and protect
children from sunburn.  7. Practice not losing your job and don't
 7. Practice safer sex. become unemployed.
 8. Take up cancer-screening opportunities.  8. Take up all benefits you are entitled to,
if you are unemployed, retired or sick or
 9. Be safe on the roads: follow the Highway
Code. disabled.
 10. Learn the First Aid ABCs: airways,  9. Don't live next to a busy major road or
breathing, circulation. near a polluting factory.
 10. Learn how to fill in the complex
housing benefit/asylum application forms
before you become homeless and
destitute.
Traditional Advice Social Determinants

 By addressing social determinants of health,
we don’t “band-aid” solutions for clients.
 We utilize a holistic approach to care and
prevention.
 We challenge long-standing paradigms in
healthcare and social work that continue to
instigate HIV stigma for clients and our
communities.
 We consider root causes for HIV risk and can
create programming to address these causes.

 NARC to include social determinants in work plan
and share research during May meeting.
 Future collaboration between NARC and QUAC to
look at CareWare data to identify trends among
clients and possibly ask more in-depth questions
in assessment and client survey.
 REHD to look at the intersections of race,
ethnicity and gender with HIV risk/access to care.
 Speakers will be present at the 2010 Iowa HIV,
STD, and Hepatitis Conference to discuss social
determinants.

 World Health Organization. (2008). Commission
on the Social Determinants of Health.
http://www.who.int/social_determinants/en/
 Commission on the Social Determinants of
Health. (2008). Closing the Gap in a Generation:
Health Equity through Action on the Social
Determinants of Health. Geneva: World Health
Organization.
 Evans, R. G., Barer, M. L., & Marmor, T. R. (1994).
Why Are Some People Healthy and Others Not?:
The Determinants of Health of Populations. New
York: Aldine de Gruyter.
 L. Donaldson, Ten Tips for Better Health (London:
Stationary Office, 1999).

Rhea Van Brocklin
AIDS Project of Central Iowa
711 E. 2nd St
Des Moines, IA 50309
515-284-0245
rheav@aidsprojectci.org