RESTRUCTURING GOVERNMENT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH

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Our health system’s focus on treatment after the fact and limited attention to prevention undermines the health and prosperity of our entire nation. In February 2008, Prevention Institute and Trust for America’s Health (TFAH) convened government officials, community advocates, and researchers to discuss the federal government’s role in addressing underlying determinants of health - the community factors in the social and physical environments that are the most influential contributors to the nation’s poor health outcomes.

Currently, not enough resources are invested in addressing the underlying determinants of health. The purpose of the meeting was to outline the elements and structures within government needed to achieve a broader community approach to health. While the focus was on federal government roles, the findings are also relevant to state and local government efforts, including California where the meeting was held. Findings from the convening were collected in the report, Restructuring Government to Address Social Determinants of Health.

Convening participants identified a number of possible solutions and below are a set of options assembled from their discussions:

• Establish high-level leadership in the federal departments and at the White House to serve as a focal point for prevention strategy and to ensure collaboration between government agencies to enhance underlying determinants of health.

• Engage key federal sectors and agencies that shape the conditions that determine health in collaborative efforts.

• Redirect funding streams to increase investment in prevention.

• Implement a system of accountability that establishes clear responsibilities and incentives for contributing to improved population health.

• Establish a data and evaluation system to monitor progress and focus public attention on the importance of determinants of health.

• Establish a strong system of training and skill building for staff at all levels of government to engage in determinants of health work.

• Translate a determinants of health focus to states and localities.

• Build political will to successfully propose and implement such changes.

The February convening and this report is the start of an ongoing process of refinement to reflect the best options for improving our nation’s health. TFAH’s Healthier America project, and the subsequent "Blueprint for A Healthier America" document, will advance a vision and roadmap for a new President and Congress for what public health should look like in the 21st century. The first piece of the upcoming Blueprint will be released as a stand alone document in July, with the rest of the document to be released in late Fall 2008.  For more information about the project, visit: http://healthyamericans.org/healthieramerica.

* These efforts are funded by The California Endowment and the Robert Wood Johnson Foundation.

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Putting Prevention at the Center of Community Well Being
www.PreventionInstitute.org