About Socio-Contextual Determinants of Health

The socio-contextual determinants of health certificate is designed to create an intellectual and professional home for Rollins master's students who have a strong scholarly commitment to studying and intervening in the socio-contextual determinants of health. This certificate provides a range of academic, research, and professional development opportunities to strengthen students' ability to advance the public's health by developing and implementing studies of, and interventions into, the socio-contextual determinants of population health and well-being.

According to the World Health Organization, socio-contextual determinants of health are:

"... the conditions in which people are born, grow, live, work, and age .... These [conditions] are shaped by the distribution of money, power, and resources at global, national, and local levels, which are themselves influenced by policy choices. [These conditions] ... are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries."

Eligibility

All students currently enrolled in a master's degree program at Rollins are eligible to enroll in the certificate program. This certificate program may be a particularly good match for students who have a strong commitment to supporting community well-being by advancing social justice, and to eradicating health disparities.

Students are encouraged to enroll in their first year at Rollins, though it may be possible to complete the certificate requirements if students enroll at the beginning of their second year.

When you are ready to enroll, please submit your Certificate Enrollment Form online.

Examples

Socio-contextual determinants operate beyond the individual. Examples include (but are not limited to):

  • Neighborhood characteristics, such as neighborhood poverty rates and male:female sex ratios
  • Social policies, such as proposed "flat taxes" and laws prohibiting same-sex marriage
  • Structural racism, including differential enforcement of drug laws across racial/ethnic groups
  • Organized social movements, such as the AIDS Coalition to Unleash Power and Occupy Wall Street, and
  • Health-care policies, such as policies that prohibit public insurance coverage for certain forms of abortion, or policies that deny public insurance based on immigration status

Rollins offers substantial coursework on the socio-contextual determinants of health, and some departments include these determinants in their mission statements. By bringing these existing resources together so they are easily accessible, and by developing new resources, this certificate program seeks to foster a community of public health practitioners who are dedicated to studying and intervening in the socio-contextual determinants of health.

Purpose

Rollins has two primary reasons for creating this certificate program:

(1) Socio-contextual factors powerfully determine distributions of health and well-being within and across populations. Socio-contextual factors can shape the extent to which individuals engage in health-promoting behaviors. For example, HIV epidemics escalate more rapidly in places where laws prohibit drug injectors from purchasing syringes from pharmacies without a prescription. Benefits accruing from interventions may decay faster when interventions fail to address socio-contextual factors that hamper sustained behavior change. Socio-contextual factors may also directly affect health, as when lax enforcement of clean air laws results in elevated asthma rates.

Socio-contextual factors are also powerful determinants of health and well-being because of their scale. These factors affect large numbers of people (e.g., all residents of a jurisdiction), and thus can contribute to a high percentage of cases of a particular outcome (i.e., they have a high etiologic fraction or population attributable risk percent), even if they have small effect sizes (e.g., an odds ratio close to 1.00).

Accordingly, several agencies have recommended that public health researchers and other practitioners investigate the impacts of socio-contextual factors on health, and develop related interventions. To illustrate:

  • Healthy People 2020 articulates national health objectives for the next decade. A core goal of Healthy People 2020 is to “create social and physical environments that promote good health for all.”
  • WHO's Final Report on the Social Determinants of Health has dedicated one of its nine "themes" to the role that policies play in shaping the health of urban residents; another theme concerns the macro-level factors that prevent some social groups from participating fully in community life (i.e., "social exclusion"); and a third theme is devoted to the ways in which healthcare systems shape distributions of health and disease across and within populations. For more information, you can access the report Here.

(2) New careers are emerging that are dedicated to studying and intervening in the socio-contextual determinants of health. City and state health departments are embracing a multilevel perspective that encompasses the socio-contextual determinants of health. Initiatives include (a) conducting health impact assessments; (b) advocating for and enacting policy changes that may support healthy behaviors, and studying the effects of these changes; (c) monitoring health outcomes at the neighborhood level and targeting interventions and resources accordingly; and (d) requiring that grantees of public funds extend their focus beyond individual-level factors to address the socio-contextual determinants of health. The certificate program helps students learn about these careers, and gain the skills and competencies they need to excel in them.

Stay Up to Date

Through the certificate program's list-serv, you can learn about GRA-ships with studies of the socio-contextual determinants of health; TA-ships for select Rollins courses listed in the certificate's roster; and conference announcements, including abstract due dates. To subscribe to this list-serv, please send an e-mail to hcoope3@emory.edu with the word "Subscribe" written on the subject line.