Community health refers to non-treatment based health services that are delivered outside hospitals and clinics. Community health is a subset of public health that is taught to and practiced by clinicians as part of their normal duties. Community health volunteers and community health workers work with primary care providers to facilitate entry into, exit from and utilization of the formal health system by community members as well as providing supplementary services such as support groups or wellness events that are not offered by medical institutions.
The Robert Wood Johnson Foundation (RWJF) is an American philanthropic organization. It is the largest one focused solely on health. Based in Princeton, New Jersey, the foundation focuses on access to health care, public health, health equity, leadership and training, and changing systems to address barriers to health. RWJF has been credited with helping to develop the 911 emergency system, reducing tobacco use among Americans, lowering rates of unwanted teenage pregnancies, and improving perceptions of hospice care.
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population. It has been described as consisting of three components. These are "health outcomes, patterns of health determinants, and policies and interventions".
Screening, in medicine, is a strategy used to look for as-yet-unrecognised conditions or risk markers. This testing can be applied to individuals or to a whole population without symptoms or signs of the disease being screened.
The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions, rather than individual risk factors that influence the risk or vulnerability for a disease or injury. The distribution of social determinants is often shaped by public policies that reflect prevailing political ideologies of the area.
Social medicine is an interdisciplinary field that focuses on the profound interplay between socio-economic factors and individual health outcomes. Rooted in the challenges of the Industrial Revolution, it seeks to:
- Understand how specific social, economic, and environmental conditions directly impact health, disease, and the delivery of medical care.
- Promote conditions and interventions that address these determinants, aiming for a healthier and more equitable society.
In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including wilderness medicine, geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.
Race and health refers to how being identified with a specific race influences health. Race is a complex concept that has changed across chronological eras and depends on both self-identification and social recognition. In the study of race and health, scientists organize people in racial categories depending on different factors such as: phenotype, ancestry, social identity, genetic makeup and lived experience. "Race" and ethnicity often remain undifferentiated in health research.
While epidemiology is "the study of the distribution and determinants of states of health in populations", social epidemiology is "that branch of epidemiology concerned with the way that social structures, institutions, and relationships influence health." This research includes "both specific features of, and pathways by which, societal conditions affect health".
The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.
Linda H. Aiken, is an American nurse and researcher who is currently the Director for the Center for Health Outcomes and Policy Research and a Senior Fellow of the Leonard Davis Institute for Health Economics. She also is the Claire M. Fagin Leadership Professor of Nursing Science and a professor of Sociology at the University of Pennsylvania, Philadelphia.
Nancy Elinor Adler was an American health psychologist. She was the Lisa and John Pritzker Professor of Medical Psychology at the University of California, San Francisco (UCSF), and director of UCSF's Center for Health and Community Sciences. Adler was known for her research on health behaviors, health disparities, and social determinants of health.
Arline Geronimus wrote about the weathering hypothesis the early 1990s to account for health disparities of newborn babies and birth mothers due to decades and generations of racism and social, economic, and political oppression. It is well documented that people of color and other marginalized communities have worse health outcomes than white people. This is due to multiple stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion, and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering", and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, social scientists investigated the biological plausibility of the weathering hypothesis in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. The weathering hypothesis is more widely accepted as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, telomere shortening, and accelerated brain aging.
Camara Phyllis Jones is an American physician, epidemiologist, and anti-racism activist who specializes in the effects of racism and social inequalities on health. She is known for her work in defining institutional racism, personally mediated racism, and internalized racism in the context of modern U.S. race relations. During the COVID-19 pandemic, Jones drew attention to why racism and not race is a risk factor and called for actions to address structural racism.
Chandra L. Ford is an American public health academic who is Professor of Community Health Sciences at the University of California, Los Angeles. She serves as Founding Director at the Center for the Study of Racism, Social Justice & Health. Her research considers relationships between racism and health outcomes.
Rachel Renee Hardeman is an American public health academic who is associate professor of Division of Health Policy and Management at the University of Minnesota School of Public Health. She holds the inaugural Blue Cross Endowed Professorship in Health and Racial Equity. Her research considers how racism impacts health outcomes, particularly for the maternal health of African-Americans.
Renee Yuen-Jan Hsia is an American emergency physician. She is a professor of Emergency Medicine and Associate Chair of Health Services Research at the University of California, San Francisco, as well as an attending physician in the emergency department at the Zuckerberg San Francisco General Hospital and Trauma Center. She is also a core faculty member of the UCSF Philip R. Lee Institute for Health Policy Studies. Her research is aimed at studying how health services and regionalization of care impact access to emergency care.
Bonnielin Swenor is an American epidemiologist who is the endowed professor of disability health and justice and director of the Johns Hopkins University Disability Health Research Center. Her work uses data-driven approaches to advance equity for people with disabilities and change public perceptions of disability, away from "living with disability" and toward "thriving with a disability".
Michelle van Ryn is an American health researcher who is the Grace Phelps Distinguished Professor at the Oregon Health & Science University. Her research considers the social determinants of health and equity in healthcare. She demonstrated that physicians' perceptions of patients was impacted by their socio-demographic status. She is the founder of Diversity Sciences, a consultancy company who provide evidence-based training for organizations looking to eliminate bias.
