Examples of How SDOH Can Be Addressed Through the 10 EPHS

What to know

Public health departments and their partners need to consider how conditions in the places where people are born, live, learn, work, play, worship, and age affect a wide range of health risks and outcomes. These social determinants of health (SDOH) can be incorporated throughout all aspects of public health work.
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Overview

The 10 Essential Public Health Services (EPHS), updated in 2020 with equity at its center, is a well-recognized framework for carrying out the mission of public health. With more attention to equity and multisector efforts, the revised EPHS is better aligned to current and future public health practice. As such, the EPHS provides a framework within which SDOH can be addressed.

EPHS Breakdown 1 - 2

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  • Include diverse sources of data and community-level determinants of health in investigations of public health issues.
  • Ensure multi-sector partner and community engagement in investigating and addressing health problems, soliciting input, and sharing information.
  • Consider the needs of populations who may be at higher risk (e.g., people experiencing homelessness, older adults, people with disabilities) during emergency responses and work with partners, including emergency management agencies, to plan accordingly.

EPHS Breakdown 3 - 4

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  • Authentically engage with community groups and people with lived experiences to understand and develop solutions to help address SDOH and improve health.
  • Convene, facilitate, or engage in multisector partnerships and coalitions with partners, such as housing, law enforcement, education, and transportation.

EPHS Breakdown 5 - 6

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  • Champion, support, and leverage policies and laws that affect SDOH and implement policy initiatives that improve health outcomes.
  • Develop and implement state/community health improvement plans that include and address the SDOH in collaboration with community partners.

  • Collaborate with multisectoral partners to ensure laws which impact SDOH are equitably applied in the community, such as housing eviction laws.
  • Develop strategies to ensure enforcement of regulations and laws which impact health, such as housing and health codes to prevent childhood lead poisoning or laws related to injury and violence prevention.

EPHS Breakdown 7 - 8

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  • Incorporate responsibilities related to addressing SDOH into position descriptions and performance evaluations.
  • Build partnerships with academic institutions to strengthen links between learning about and the practice in addressing SDOH.

EPHS Breakdown 9 - 10

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  • Actively engage governance bodies (e.g., board of health, health council) to understand and address SDOH in the community.
  • Establish robust information technology services that allow for collection and sharing of SDOH data.
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