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The Sociocultural Environment and Health: Systematic Reviews of Community Interventions. Sociocultural Review Team. A Tool for Informed Decision-Making. The Community Guide provides a set of evidence-based recommendations for public health action to improve community health.
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The Sociocultural Environment and Health: Systematic Reviews of Community Interventions
A Tool for Informed Decision-Making The Community Guideprovides a set of evidence-based recommendations for public health action to improve community health. The Community Guide summarizes what is known about the effectiveness and feasibility of community-based health interventions by conducting systematic reviews of the intervention literature.
Community Guide Reviews www.thecommunityguide.org
Community Interventions to Promote Health-Enhancing Social Environments The sociocultural environment exerts a fundamental influence on health at the neighborhood, community, and societal level. The Sociocultural Environment reviews in the Guide will include evaluations and recommendations on interventions to reduce health inequalities through modifying the social environment.
SOCIOCULTURAL DETERMINANTS:SOCIAL RESOURCES AND THEIR DISTRIBUTION IMPACT HEALTH Social Resources Standard of living Culture and history Social institutions Built environments Political structures Economic systems Technology Physical Environment Equity & Social Justice (Resource Distribution) COMMUNITY HEALTH
Social Resources and their Distribution Adequate social resources are prerequisite to maintaining a supportive social environment for health. Equity and social justice are quintessential to health. They are conditions that characterize the distribution of resources among the population.
Neighborhood Living Conditions Community Development and EmploymentOpportunities Civic Engagement & Participation in Decision-Making Community Customs, Norms and Processes Opportunities for Learning and Developing Capacity Health Promotion, Prevention and Care Opportunities I N T E R M E D I A T E O U T C O M E S OUTCOME COMMUNITY HEALTH
Intermediate Outcomes • Between root social determinants and health outcomes are observable community conditions amenable to intervention programs: • neighborhood living conditions, school and work opportunities, community norms, neighborhood cohesion, available health and social services • These are quantifiable conditions and thus offer a means to account for why communities with few social resources experience poorer health.
SOCIOCULTURAL ENVIRONMENT FRAMEWORK Intermediate Outcomes Determinants EQUITY AND Neighborhood Living Conditions SOCIAL JUSTICE Community Development and Employment Opportunities SOCIAL RESOURCES Standard of living Culture and history Social institutions Built environments Political structures Economic systems Technology Civic Engagement & Participation Health Outcome in Decision-Making HEALTHIER COMMUNITIES Community Customs, Norms and Processes Opportunities for Learning and Developing Capacity PHYSICAL ENVIRONMENT Natural Resources Health Promotion, Prevention and Care Opportunities .
Priority Interventions for Health Enhancing Social Environments • RANKED BY POTENTIAL IMPACT ON IMPROVING COMMUNITY HEALTH • Child development programs (Head Start, Healthy Start, etc.). • Adequate public investment in education. • “Living wages” to move working families above poverty. • Access to quality health care for all ages. • Mixed income housing to decrease segregation by socioeconomic status. • Programs to reintegrate stigmatized populations. • Parenting classes in schools, churches, health agencies, etc. • Neighborhood schools as site of numerous community support programs. • Family-focused, one-stop health and human services centers. • Adequate health benefits with employment.
Access to Culturally Competent Health Care • Access to culturally competent health care • Diversity training • Culturally accommodating settings • Interpreter services • Culturally appropriate health education materials • Diverse staffing • Insufficient number of evaluation studies to draw conclusions about intervention effectiveness
For Further Information • Morbidity and Mortality Weekly Report on Community Guide Sociocultural Environment reviews coming in November 2001 • Reviews will be published in the American Journal of Preventive Medicine in Fall 2002 • Community Guide website: www.thecommunityguide.org