building a healthier future: addressing structural determinants of health equity

We are exploring the initiatives that Dayton Children’s is working on to improve health equity within and outside of the hospital walls. We also discussed how Dayton Children’s is leading efforts to address social determinants of health. 

Addressing structural determinants of health is also important to our hospital’s mission of improving optimal health for every child within our reach. In this article, we’ll explain more where these structural determinants of health come from and how we plan to address them! 

According to the National Academies of Sciences, Engineering, and Medicine, health inequity arises from many root causes that can be organized in two clusters: 

1. The unequal allocation of power and resources—this includes goods, services, and societal attention—which manifests itself in unequal social, economic, and environmental conditions, also called the determinants of health. 
2. Structural inequities that organize the distribution of power and resources differentially across lines of race, gender, class, sexual orientation, gender expression, and other dimensions of individual and group identity. 

System-level or societal level changes are needed to reduce poverty, eliminate structural racism, improve income equality, improve educational opportunity, and fix the laws and policies that perpetuate structural inequities.  

Tackling unemployment, concentrated poverty, and school dropout rates can seem overwhelming, and it’s not something as a hospital we are doing alone.  However, as one of the region’s largest employers and an advocate for the health of children and families in our community, our voice is important. We know that working with residents, businesses, state and local government, and other local institutions can promote health equity.  

Here are some of the ways Dayton Children’s is addressing societal-level challenges that lead to inequity: 

• In partnership with the City of Dayton we participate in the Volunteer Income Tax Assistance (VITA) program, where we offer tax preparation and filing services to families at or below a certain income level.  
• Our community-engaged research focuses on authentically elevating community voices throughout the research process and actively partnering with the community to conduct research of meaning to them.  
• Our community health needs assessment obtains input from the community to identify specific pediatric health priorities along with the structural and societal-level barriers to health. Then we create our community health improvement plan to address the top pediatric health issues.