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Ethnicity & Disease, Volume 27, Supplement 1, 2017 273
Foreword
While health disparities have been documented for
years, we have learned that, to understand the causes
of health disparities, we need to focus above and be-
yond individual risk factors and turn our attention to
the social determinants of health (SDOH) or the causes
of the causes.1 However, it was not until the end of the
20th century with the publication of e Solid Facts2
by the World Health Organization,that these determi-
nants were translated into action to address health ineq-
uities within and between countries. In fact, e Solid
Facts summarizes the evidence on SDOH into 10 mes-
sages to provide a guide to policy makers and the public.
Despite health disparities being pervasive in the United
States, the SDOH model has only recently emerged as an im-
portant foundational element supporting work to eliminate
health disparities. Interestingly, Healthy People 2020 recog-
nizes the importance of SDOH by including it in one of its
four overarching goals: “Create social and physical environ-
ments that promote good health for all.” is goal is lim-
ited relative to the determinants proposed by WHO (social
gradient, stress, early life, social exclusion, work, unemploy-
ment, social support, addiction, food and transportation,
2003)2 and the ones used in Canada (income and income
distribution, education, unemployment and job security,
employment and working conditions, early childhood de-
velopment, food insecurity, housing, social exclusion, social
safety network, health services, Aboriginal status, gender,
race and disability).3 e Healthy People 2020 goal focuses
on ve key areas: economic stability, education, social and
community context, health and health care, and neighbor-
hood and built environment (http://tinyurl.com/z32yfnv).
I commend and congratulate the guest editors of the
supplement for being ahead of the game in nding creative
ways to eliminate health disparities in the United States.
is supplement comprises a collection of nine articles em-
anating from research supported by the Academic-Com-
Foreword: Addressing
the sociAl determinAnts oF heAlth
through AcAdemic-community
PArtnershiPs
Luisa N. Borrell, DDS, PhD
Associate Editor, Ethnicity & Disease
Professor & Chair
Department of Epidemiology & Biostatistics
Graduate School of Public Health & Health Policy
City University of New York
Ethn Dis. 2017;27(Suppl 1):273-276;
doi:10.18865/ed.27.S1.273.
Keywords: Academic-Community Partnership;
Social Determinants of Health
ese articles represent research and
programs exploring individual-,
community- and society-level
determinants of health to address the
elimination of health disparities.
munity Engagement (ACE) Core of the Mid-South Trans-
disciplinary Collaborative Center for Health Disparities
Research (Mid-South TCC). e Mid-South TCC used a
combination of three models - SDOH, the socioecologi-
cal model, and community-based participatory research
(CBPR) - to establish an infrastructure to investigate the
SDOH related to social, economic, cultural, and environ-
mental factors driving and sustaining health disparities.
Specically, in addition to its involvement in all research
projects funded by the Research and Pilot Core of the
Mid-South TCC, the ACE Core funded and supported 15
community projects across its six partner states—Alabama,
Louisiana, Mississippi, Arkansas, Tennessee, and Kentucky.
Ethnicity & Disease, Volume 27, Supplement 1, 2017
274
Foreword - Borrell
ese articles represent research and programs exploring
individual-, community- and society-level determinants
of health to address the elimination of health disparities.
Rese aRch a nd PRogRa mming at the
individual-lev el
Two articles in this section focus on awareness and
access to a healthy diet. ese research articles bring at-
tention to promotion, awareness and use of fresh food
markets and farmer’s markets in New Orleans, Louisi-
ana. For instance, Ferdinand et al tackle how barriers to
buying fruit and vegetables could be removed by provid-
ing monetary incentives to a low-income minority com-
munity. Moreover and also in New Orleans, Nuss et al
found that more than 80% were not aware that a local
farmer’s market accepted electronic benet transfer pay-
ment as a form of pay. With barriers to promoting fruit
and vegetable consumption identied, low-income com-
munities will be more likely to address and nd solu-
tions to health problems related to healthy eating habits.
Rese aRch a nd PRogRa mming at the
commu nit y-level
is set of articles underscores the need to address and
identify benets around transportation, social support
and social networks in minority communities. ese ar-
ticles stress the identication of 1) bikeshare as a poten-
tial transportation option in low-resource neighborhoods
(Oates et al); 2) violence and lack of neighborhood cohe-
sion and safety as community concerns (Bateman et al);
and 3) how theories of social networks and social capital
can enhance academic-community partnerships (Bright
et al). Hood et al illustrate how academic-community
partnerships led to collaborations between higher edu-
cation institutions and their surrounding communities
through funding of innovative projects addressing health
disparities and improving overall community well-being
in the greater Birmingham area. Finally and another ex-
ample of such partnerships, results of a survey conducted
by Skizim et al showed community interest in the avail-
ability of screenings for chronic diseases, exercise classes
at local churches, nancial management workshops,
and health fairs run by local community organizations.
Rese aRch a nd PRogRa mming at the
socie ty-lev el
In this section, the guest editors present two articles
focused on policy, systems and environmental (PSE) in-
terventions that target individuals such as elected ocials
and stakeholders who could inuence policy around obe-
sity prevention programs (Betancourt et al) and identifying
correlates of fruit and vegetables consumption (Bateman
et al). ese articles call attention to PSE strategies and
interventions that may improve health outcomes, especial-
ly chronic diseases including heart disease, among high-
risk populations such as low-income African American.
conclusions
By examing SDOH, our goal is to identify the roots
of inequality beyond individual-level factors to include
the society-level structural, social and economic factors to
promote policy changes leading to health equity within an
individual’s context. To that end, the academic-commu-
nity partnerships and the processes of community-based
participatory research in the Mid-South TCC programs
have provided a voice to call attention to the issues aect-
ing low-income and low-resourced communities. us,
the Mid-South TCC needs to be commended for its suc-
cessful work with communities in a six-state region; their
work provides a model for academic-community part-
nerships that should be replicated in other communities.
R
1. Marmot MG, Wilkinson RG. Social Determinants of Health. Oxford:
Oxford University Press. 2006.
2. Wilkinson R, Marmot M. e Solid Facts: Social Determinants of Health.
Copenhagen: Centre for Urban Health, World Health Organization.
2003.
3. Bryant T, Raphael D, Schrecker T, Labonte R. Canada: a land of missed
opportunity for addressing the social determinants of health. Health Policy.
2011;101(1):44-58. https://doi.org/10.1016/j.healthpol.2010.08.022.
PMID:20888059.
Ethnicity & Disease, Volume 27, Supplement 1, 2017 275
Foreword - Borrell
acknowledgment
is work was supported by a grant from the National Institutes on Minority Health and Health Disparities
(U54MD008176).
Ethnicity & Disease thanks the NIMHD and all those involved in the research, interventions and development of
articles reecting their work in the community: the Mid-South TCC principal investigators, guest editors, guest manag-
ing editor, and the community partners represented in this set of research articles.
Mid-South TCC Principal Investigators
Mona N. Fouad, MD, MPH, University of Alabama at Birmingham, Lead PI
Edward E. Partridge, MD, University of Alabama at Birmingham, Co-PI
Marinelle Payton, MD, PhD, MPH, Jackson State University, PI
Lucio Miele, MD, PhD, Louisiana State University Health Sciences Center, PI
Richard Scribner, MD, MPH, Louisiana State University Health Sciences Center, Co-PI
Mario Sims, PhD, University of Mississippi Medical Center, PI
Guest Editors
Mona N. Fouad, MD, MPH
Marinelle Payton, MD, PhD, MS, MPH
Yu-Mei M. Schoenberger, PhD
Richard Scribner, MD, MPH
Guest Managing Editor
Lori Brand Bateman, PhD
Community Partners Involved in Projects Represented in this Supplement
Arkansas Coalition for Obesity Prevention, Greenbrier, Arkansas
Black People Run, Bike and Swim, Birmingham, Alabama
City of Bessemer Mayor’s Oce, Bessemer, Alabama
City of Hattiesburg Mayor’s Oce, Hattiesburg, Mississippi
City of Knoxville Mayor’s Oce, Knoxville, Tennessee
City of New Orleans Mayor’s Oce, New Orleans, Louisiana
City of Oak Ridge Mayor’s Oce, Oak Ridge, Tennessee
Collaborative Community Advisory Boards, Jackson, Mississippi
Community Engagement Group, New Orleans, Louisiana
Daughters of Charity, New Orleans, Louisiana
Dillard University Oce of Community and Church Relations, New Orleans, Louisiana
East Lake Market, Birmingham, Alabama
Edwards Mayor’s Oce, Edwards, Mississippi
Gentilly Community, New Orleans, Louisiana
Ethnicity & Disease, Volume 27, Supplement 1, 2017
276
Foreword - Borrell
Gulf States Health Policy Center Bayou La Batre (Mobile) Area Coalition, Mobile, Alabama
Gulf States Health Policy Center Birmingham Area Coalition, Birmingham, Alabama
Gulf States Health Policy Center Hattiesburg Area Health Coalition, Hattiesburg, Mississippi
Health & Wellness of Livingston, Livingston, Alabama
Hobson City Mayor’s Oce, Hobson City, Alabama
Hollygrove Market and Farm, New Orleans, Louisiana
Innovative Behavioral Services, Jackson, Mississippi
Jackson State University Jackson Heart Study Community Health Advisors, Jackson, Mississippi
Jeerson County Committee for Economic Development, Birmingham, Alabama
Jeerson County Department of Health, Birmingham, Alabama
Kentucky Department of Public Health, Frankfort, Kentucky
Kingston Coalition, Birmingham, Alabama
Lane Lincoln CME, Hodgenville, Kentucky
Lincoln Trail District Health Department, Elizabethtown, Kentucky
Louisiana Public Health Institute, New Orleans, Louisiana
Meharry Medical College, Nashville, Tennessee
New Horizon Ministries, Inc., Jackson, Mississippi
Norwood Resource Center, Birmingham, Alabama
One Great Community Council, Birmingham, Alabama
Rapides Foundation, Alexandria, Louisiana
Sankofa Community Development, Inc., New Orleans, Louisiana
Sign of the Dove Ministries, Radcli, Kentucky
Stewpot Community Services, Jackson, Mississippi
University of Mississippi Medical Center Community Health Advocate Training Program, Jackson, Mississippi
Zyp Bikeshare/Rev Birmingham, Birmingham, Alabama
