Local nonprofit agencies addressing critical social determinants of health for those in need

This article was written for our sponsor, North Carolina Community Action Association.

There are physical determinants of health — things like nutrition and exercise, but there are also social determinants of health (sometimes referred to as "social drivers") such as a person's education, living environment, socioeconomic status, employment, transportation and more.

As the N.C. Community Action Association website explains, "Social determinants of health are factors of our physical, emotional and social environment that have key impacts on our health. In fact, 80 percent of our health outcomes are determined by where we live, work and play."

"Social determinants are the conditions in which people are born, grow, live, work, and age that shape our health," said Kathy Payne, executive director of Yadkin Valley Economic Development District, a local Community Action Agency.

"Social determinants of health are basically any unmet need an individual has," added Patsy Davis, executive director of Mountain Projects, Inc, another local Community Action Agency that serves Haywood and Jackson Counties.

Community Action Agencies are nonprofit organizations that equip low-income citizens with the tools and resources they need to become self-sufficient through structured programming. These federally funded CAAs were created as the result of the Economic Opportunity Act of 1964 to address the systemic problem of poverty in our nation.

Long before the pandemic hit the United States, Community Action Agencies have been addressing the social determinants of health for impoverished people across the nation, including 34 local agencies in North Carolina that serve counties all over the state from the mountains to the coast. Their work has never been more timely as social determinants of health are increasingly relevant given current times as people are being impacted by the effects of COVID-19 whether through unemployment, lack of insurance, or remaining homebound.

So how does something like housing, for example, affect a person's health?

"We see a lot of folks living in inadequate housing. Unfortunately in many parts of North Carolina, we don't have an adequate supply of affordable housing and rentals," said Davis. "If a person cannot keep heat in their home or their home is not safe and sanitary — that's a foundation for their social determinants of health to be at risk. Especially for children; there are lots of studies that talk about how adequate housing helps a child be successful."

"You can exercise and you can have good food to eat, but if you're cold at night, then that's a problem," Davis finished.

Beyond housing, things like education, income, transportation and other social determinants can be predictors of health. Lack of money creates financial barriers to paying for electricity, heating, food and other necessities. Being without a car or not having access to public transportation makes getting to school, work or a healthcare appointment almost impossible. All of these scenarios contribute to lower health outcomes that plague impoverished and rural communities.

The N.C. Department of Health and Human Services curated the following list of statistics on conditions such as housing instability, food insecurity, interpersonal violence, and unmet transportation needs that impact a person's health:

More than 1.2 million North Carolinians cannot find affordable housing

One in 28 NC children under age 6 is homeless

North Carolina has the 8th highest rate of food insecurity in the United States, with more than one in five children living in food insecure households.

47 percent of North Carolina women have experienced intimate partner violence

"We know that a person's education and income are some of the greatest predictors of their health. Poverty limits access to healthy food, which usually costs more. More education is a predictor of better health. When an individual has unstable housing, a low-income, or they're in unsafe neighborhoods — this affects their overall wellbeing," said Payne. "We have many programs within our agencies that address different types of these determinants."

Community Action Agencies provide several different programs and services for the entire family. While the following is not an exhaustive list, it is one that reflects services that address areas where gaps in social determinants of health exist:

Community Services Block Grants that "provide funds to alleviate the causes and conditions of poverty in communities"

Head Start, a United States Department of Health and Human Services program that provides comprehensive early childhood education, health, nutrition, and parent involvement services to low-income children and families

Employment services such a resume writing assistance, interviewing help, and “dressing for success” courses

Healthy Homes Initiative, a program in collaboration with Blue Cross and Blue Shield of North Carolina that provides families with the crucial home repairs, such as carpet removal or accessibility/fall prevention installation, that they need to improve their health

Weatherization program in partnership with Duke Energy that reduces energy consumption for income-qualified customers by directly installing energy-efficient measures and providing education on energy efficiency

Emergency assistance for domestic violence and sexual assault victims

Transportation program that provides transportation for people to get to medical appointments, school or work

"We're a member of the NC Public Transit Association. YVEDDI does about a little over a million service miles per year," said Payne. "A person might need transportation to get to a medical appointment or to a Head Start classroom."

Speaking of Head Start, while often seen as a child program, Payne emphasized that CAAs work with the entire family to address things like nutrition and setting financial, education and employment goals for the household.

Addressing the social determinants of health for one individual can oftentimes lead to a ripple effect in communities. Payne recounted an experience of a woman who was helped by YVEDDI who went on to open her own food pantry — a testament to what CAAs stand for: self-sufficiency.

"A program participant who used our Head Start services went on to earn her doctorate and became a university professor and ended up working for a national Head Start program herself," said Payne. "Our agency is an umbrella of many of these types of programs and our mission is to help folks achieve success in their community. We're building bridges to get folks to the right places to address their various needs."

This article was written for our sponsor, North Carolina Community Action Association.