Examples of How the Social Determinants of Health Can Be Addressed Through the 10 Essential Public Health Services

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), and actions to address the resulting health inequities, can be incorporated throughout all aspects of public health work.

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 and provides a framework within which SDOH can be addressed. The revised EPHS includes more attention to equity and multi-sector efforts so as to better align to current and future public health practice.

Interventions that modify SDOH are integral to advancing health equity. The examples below provide awareness of how the 10 EPHS can better incorporate consideration of SDOH and advance health equity.

EPHS 1: Assess and monitor population health status, factors that influence health, and community needs and assets
Number 1
EPHS 2: Investigate, diagnose, and address health problems and hazards affecting the population
Number 2
  • 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 needs for 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 3: Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it
Number 3
EPHS 4: Strengthen, support, and mobilize communities and partnerships to improve health
Number 4
  • 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 5: Create, champion, and implement policies, plans, and laws that impact health
Number 5
EPHS 6: Utilize legal and regulatory actions designed to improve and protect the public’s health
Number 6
EPHS 7: Assure an effective system that enables equitable access to the individual services and care needed to be healthy
Number 7
  • Connect eligible community members to health and social services such as
    • Medicaid, including its medical, mental health, and housing benefits
    • Temporary Assistance for Needy Families
    • Supplemental Nutrition Assistance Program
  • Ensure health services, including behavioral and mental health services, are culturally and linguistically appropriate
  • Collaborate with multisector partners (e.g., transportation, housing) to address and remove barriers to care
EPHS 8: Build and support a diverse and skilled public health workforce
Number 8
EPHS 9: Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement
Number 9
EPHS 10: Build and maintain a strong organizational infrastructure for public health
Number 10
  • Actively engage governance bodies (e.g., board of health, health council) to understand and address SDOH in the community
  • Conduct strategic planning and establish organizational health equity policies in ways that utilize health equity frameworks and public health ethics
  • Establish robust information technology services that allow for collection and sharing of SDOH and health equity data