Advancing health equity in the U.S. requires action from more than just public health and health care leaders. The research is clear that policies that shape the environments in which people live have a greater impact on health outcomes than the care provided in doctors’ offices. These structural and social determinants of health (SDOH)—factors including education, transportation, housing, language, safety, racism and discrimination, environment, and others—are influenced by policy decisions at the local, state, national, and Tribal levels that have historically failed to consider their potential downstream impacts on health outcomes.
Marginalized communities are more likely to be harmed by such policies. The COVID-19 pandemic was a prime demonstration of the disproportionate impacts of factors such as housing conditions, access to preventive care, religion, and workplace regulations on people’s ability to protect themselves and their families. (author introduction)