Advocacy Opportunities to Address Social Determinants of Health

Education, Training, and Career Development (ETCD) Council Corner

Jamie S. Bodenlos, PhD, Morgan S. Lee, PhD, MPH, CPH, and Amy G. Huebschmann, MD, MS

Human progress is neither automatic nor inevitable... Every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.
Martin Luther King, Jr.

Welcome to the “ETCD Council corner” of Outlook! In each issue of Outlook, look to the ETCD Council corner for information related to our mission, which is to provide SBM members with opportunities and support to enhance their training and career development throughout all phases of their careers in behavioral medicine. Given the upcoming annual meeting theme of “Leading the Narrative,” our ETCD council authors decided to use this issue to discuss a relevant hot topic: how behavioral health professionals in practice, research, and/or teaching roles may address social determinants of health.

Our SBM members are diverse in the work that we do: Some practice as psychologists or physicians, others are researchers and educators in small or large universities, and many spend their careers conducting NIH-funded grants in medical schools. Regardless of our professional roles, we are all familiar with how unmet social needs — often termed “social determinants of health” — affect health and well-being.

At times, these social needs can be frustrating to health care providers, many of whom view these factors as fixed and not amenable to our behavioral interventions. Behavioral health professionals try to measure these social needs in our research, often as confounders or moderators, but they aren’t typically the focus of our interventions. After all, how can we possibly change the communities in which our patients and participants grow up; their access to clean water, air, and food; their health care access; or the quality of their schools? It can feel quite frustrating and hopeless at times as we look at the ways in which these systematic factors have put the people we work with at risk for disease and other poor outcomes, often reducing their quality of life and shortening their life span.

While we may feel we are doing right by the individuals affected by these social disadvantages by working with them in our fields of research and practice, is there more we could be doing? This question is especially pertinent because data suggest that income inequality and the resultant social divide are worsening.

A good first step is to become aware of specific policies or legislative bills that might be an avenue to help change the circumstances for the disadvantaged groups we serve. For example, are there bills under consideration in Congress or our state’s legislature that may affect health care or public schools? With this knowledge in hand, we are able to hone our efforts on a specific issue that we can work towards changing. We should strongly consider using our privilege and our knowledge to educate community members, policy makers, and health care workers on the ways in which the policy or law we have identified could help those who are negatively affected by social factors. We can do this through lectures in our courses; writing op-eds to different outlets; writing letters to policy makers at federal, state, or local levels; or by organizing or simply getting involved in groups whose purpose is to facilitate change.

Consider taking a step towards advocacy by educating others about social determinants of health. For example, if you are a practicing health care provider, you could reach out to local high schools or colleges and volunteer to speak to students about these social needs or offer to do an interview with your local newspaper to share your knowledge on a certain topic. Many other options are available as well: consider starting a public awareness campaign through social media or blogging, running for a public position in your town or state so that you can use your expertise to better your community, or donating your time to directly help others by volunteering in your community.

Don’t be afraid to use your voice to make a change. As behavioral health professionals, we have so much knowledge and experience that we never share. Why not take a risk and use your voice to advocate for the less privileged in our society?