Getting Under the Skin: Using Knowledge about Health Inequities to Spur Action

Susan Eaton and Sara Abiola

For more than a decade, public health researchers and doctors have established that people who live in neighborhoods of concentrated disadvantage are far more likely to experience high levels of damaging stress, suffer from mental health challenges, develop chronic diseases, and die young. The research consensus is clear. But in spite of this knowledge, programs and even most scholarly research continue to focus narrowly on what poor people should do, for example, to improve their diet and exercise regimens. But given the enormous impact of neighborhood conditions on health, research strongly suggests that urging individuals to change their behaviors is only part of the solution. Meanwhile, perhaps because of the challenges it implies, the question of how to move this knowledge into action is still too often evaded.

This brief has two purposes. The first is to translate knowledge from the so-called “social determinants of health” arena into a useable form. The second purpose is to explore how to best use this knowledge to lobby for, and create policy and programming changes on the ground in, communities of concentrated disadvantage. Many community groups, elected leaders, and others have inspired a variety of positive changes, in part by using knowledge and data from the social determinants of health field. At the end of this brief, we offer concrete recommendations, action steps and resources for community advocates, elected leaders, educators, and others working to increase opportunities for people who live in neighborhoods of concentrated disadvantage.