Cited by 512Health disparities and outcomesPublic Health and Social InequalitiesPublic Health Policies and Education

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Moving Upstream: How Interventions That Address the Social Determinants of Health Can Improve Health and Reduce Disparities

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Williams, David R., Costa, Manuela V., Odunlami, Adebola O., Mohammed, Selina A.·2008·Journal of Public Health Management and Practice

DOI 10.1097/01.phh.0000338382.36695.42PMC PMC3431152

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Abstract

There is considerable scientific and policy interest in reducing socioeconomic and racial/ethnic disparities in healthcare and health status. Currently, much of the policy focus around reducing health disparities has been geared toward improving access, coverage, quality, and the intensity of healthcare. However, health is more a function of lifestyles linked to living and working conditions than of healthcare. Accordingly, effective efforts to improve health and reduce gaps in health need to pay greater attention to addressing the social determinants of health within and outside of the healthcare system. This article highlights research evidence documenting that tackling the social determinants of health can lead to reductions in health disparities. It focuses both on interventions within the healthcare system that address some of the social determinants of health and on interventions in upstream factors such as housing, neighborhood conditions, and increased socioeconomic status that can lead to improvements in health. The studies reviewed highlight the importance of systematic evaluation of social and economic policies that might have health consequences and the need for policy makers, healthcare providers, and leaders across multiple sectors of society to apply currently available knowledge to improve the underlying conditions that impact the health of populations.

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Authors: Williams, D. R., Costa, M. V., Odunlami, A. O., & Mohammed, S. A.
Affiliations: Harvard University (US)
National Heart, Lung, and Blood Institute (US)
ORCID: Williams, David R.
Mohammed, Selina A.
Venue: Journal of Public Health Management and Practice
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2008-11
Volume: 14
Issue: 6
Pages: S8-S17
ISSN: 1078-4659 (ISSN-L)
DOI: 10.1097/01.phh.0000338382.36695.42
PMC: PMC3431152
OpenAlex: W2025820027
Cited by: 489
References: 44
Citations by year: 2026: 22 · 2025: 32 · 2024: 40 · 2023: 47 · 2022: 36 · 2021: 45 · 2020: 47 · 2019: 26 · 2018: 41 · 2017: 26 · 2016: 24 · 2015: 23 · 2014: 12 · 2013: 18 · 2012: 20
FWCI: 10.27
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Public Health Management and Practice (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5u01hl087322-05)
National Heart, Lung, and Blood Institute (U01-HL 087322, U-01 HL 87322-02, 3U01HL087322-02S1, R01HL069413)
National Institute of Mental Health (R01MH059575, R01 MH 59575)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Health › Public Health and Social Inequalities
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
Keywords: social determinants of health, health disparities, racial and ethnic disparities, socioeconomic status, housing conditions, neighborhood conditions, upstream interventions, health policy evaluation, health equity
MeSH terms: Delivery of Health Care, Humans, Social Class, United States, Health Status Disparities, Healthcare Disparities

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Moving Upstream: How Interventions That Address the Social Determinants of Health Can Improve Health and Reduce Disparities

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