The social determinants of health and their impact on child welfare

The social determinants of health and their impact on child welfare
By Colleen Murray
Colleen Murray
Senior Director, Research Science
Jan 10, 2022
3 MIN. READ
All children deserve an equal opportunity to thrive—collaboration across federal, state, and local levels is needed to address environmental justice and the impact of climate change on the health of children.

Health and welfare are critical to a child's mental and physical development. Yet there are many external factors that influence a child’s health, and those factors do not impact all children equally. Children living within under-resourced communities often face environmental and social inequities that put their overall well-being at risk.

CDC director, Dr. Rochelle Walensky, declared racism a public health threat that “directly affects the well-being of millions of Americans.” In addition, we know climate change has exacerbated the risk of poor health outcomes—particularly for children. Many children’s health and welfare agencies are increasingly viewing their missions through a health equity lens.

In our recent webinar, “Exploring child welfare through the lens of environmental justice and health equity,” we discussed the social determinants of health and their impact on children with esteemed panelists from federal, state, and community levels. But, taking a step back, what are social determinants of health and why are they critical to better understanding public health inequities?

The five key areas of social determinants of health

Social determinants of health (SDOH) are the complex, integrated, and overlapping social structures, policies, and economic systems that affect health and quality of life outcomes. Disparities across these areas can also be a major cause of health inequities, particularly when populations do not have equal access to imperative resources.

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The five key areas of the CDC’s SDOH framework:

  1. Healthcare access and quality: The connection between people’s access to and understanding of health services and their own health. 
  2. Education access and quality: The connection of education to health and well-being. 
  3. Social and community context: The conditions in which people live, work, play, and access care. 
  4. Economic stability: The connection between the financial resources people have—income, cost of living, and socioeconomic status—and their health.  
  5. Neighborhood and built environment: The connection between where a person lives—housing, neighborhood, and environment—and their health and well-being. 

Climate change, SDOH, and children’s health outcomes 

Climate change events such as rising heat indexes and sweeping wildfires have implications across each area of the SDOH framework. For children, climate change events exacerbate existing health inequities.

For example, the extreme heat events in the pacific northwest last summer disproportionately impacted under-resourced communities. It cannot be assumed that everyone has access to air conditioning in their homes and schools. The rising heat index can result in discomfort and inhibit children’s ability to focus, leading to decreased educational attainment.

In addition, climate change events—such as wildfires or severe hurricanes—also cause school closures and disrupt instructional routines. This lack of stability can hamper children’s social and cognitive learning and can have a negative impact on their mental health.

If vulnerable populations are not considered in climate action plans, both the negative and disproportionate implications of climate change on children’s health will persist.

Environmental injustice, racism, and public health 

Similarly, environmental injustice causes vast health inequities that impact our children. And those health inequities across under-resourced communities—including American Indian and Alaska Native (AI/AN) communities—contribute to higher rates of chronic disease and underlying risk factors.

For example, COVID-19 has magnified the existing lack of protections in place within the social and community context. This is notably apparent for children within low-wealth and Black, Indigenous, and people of color (BIPOC) communities. “Persistent health disparities combined with historic housing patterns, work circumstances, and other factors have put members of some racial and ethnic minority populations at higher risk for COVID-19 infection, severe illness, and death” according to the CDC. This is particularly detrimental for children with preexisting conditions—such as asthma—which may put them at greater risk if exposed to COVID-19.

Interrupting the narrative and prioritizing prevention

To achieve a prevention-oriented system where children and families can live healthy and safe lives, vulnerable communities will need additional resources and continued support. As child welfare systems prioritize prevention, there is an intentional focus on multi-sector partnerships and collaborative investments—all necessary to build and support healthy, thriving communities. For movement "upstream" on the prevention continuum, it will be imperative for public health professionals and direct service providers to look at the environmental and contextual factors that are impacting SDOH.

Watch our on-demand webinar to learn more about social determinants of health, their impact on children, and how climate change has amplified the disparities across determinants in under-resourced communities.

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Meet the author
  1. Colleen Murray, Senior Director, Research Science