The Social Determinants of Health: Elevating Voices and Understanding through Partnership

Imagine you need to schedule a doctor’s appointment but the only available time you have outside of work are weekends and evenings, which is when the office is closed. In order to arrive anywhere on time you have to strategically navigate the bus schedule and account for walking distance between bus stops. Imagine having to choose between paying for groceries or medications. Sometimes it feels like the systems in place were not built for you.

This experience may or may not personally resonate, but it is clear that health and wellbeing are more than just doctor’s visits, as it entails the “the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness.” The World Health Organization refers to this as the social determinants of health, which can include: “housing instability, utility needs, food insecurity, interpersonal violence, and transportation”. This emphasis on systems calls for more collaborative efforts between community services and healthcare providers.

Community resource fair at Ogden High School.

The Multicultural Commission has partnered with Intermountain Healthcare’s Utah Alliance for Determinants of Health (The Alliance) to address gaps in communication that limit the sustainability and reach of community health interventions among marginalized groups. The Alliance selected Washington County and Weber County as pilot areas based on localized needs, but with the intent to address the social determinants of health state-wide. According to Intermountain Healthcare, “[t]his demonstration comes with an investment of $12 million over three years to address social needs. Findings from the demonstration can be scaled within Intermountain Healthcare, nationally, and globally in future years. ” Currently, the partnership will focus on identifying the concerns of marginalized communities through public discussions involving community stakeholders.

Efforts to do so are underway and have started in Ogden. On July 8th, the Multicultural Commission and Intermountain Healthcare facilitated a community resource fair and public forum at Ogden High School. This event was co-organized by the Utah Division of Multicultural Affairs and Intermountain Healthcare partners. The collaboration aligns with the division’s community-engagement pillar that emphasizes connecting people to opportunities and elevating marginalized voices. Over 70 community members and organizations attended to learn more about what resources were available. The public forum further highlighted the need for cultural sensitivity from service providers as well as aligning services to overall wellbeing. This expanded the definition of what it means to be healthy.

Mikelle Moore, Senior Vice President and Chief Community Health Officer for Intermountain Healthcare, shared that “The Alliance for the Determinants of Health seeks a collaborative approach to addressing and achieving health equity in our communities,” calling for more non-medical health interventions. In applying this, Moore reiterated that “We must work together as a community to seek more equitable health outcomes and use our creativity, our unique community insights and our combined strengths to find a holistic healthcare solution to make our population healthier.”

“We must work together as a community to seek more equitable health outcomes and use our creativity, our unique community insights and our combined strengths to find a holistic healthcare solution to make our population healthier.”

Mikelle Moore
Intermountain Healthcare
Community members discussing concerns.

To establish commonalities within a diverse audience, Satin Tashnizi, a Multicultural Commission member, led a reflective activity where attendees were asked a series of questions to which they responded by raising  their hands. The purpose of the activity was to encourage people to share their “truths”, establishing a comfortable space for a wide range of opinions and concerns.

 This activity set the tone for facilitators, Bridget Shears of the Martin Luther King Jr. Human Rights Commission and Angela Choberka of Intermountain Healthcare, to lead an open discussion on community health. The questions ranged from “What do you think about when you hear the word ‘health’?” to “How does your community support your health and well-being?” Responses included action-based ideas and concerns about the current access to healthcare and social services.

Lucy Transtrum of the Ogden School District Equity and Access Team, emphatically stated, “We need to acknowledge that homelessness, hunger, and emergencies are not 9 to 5. Healthcare is so much more than just going to the doctor.”

“We need to acknowledge that homelessness, hunger, and emergencies are not 9 to 5. Healthcare is so much more than just going to the doctor.”

Lucy Transtrum
Ogden School District
Betty Sawyer sharing her thoughts.

Betty Sawyer, past president of the NAACP and current Community Engagement Coordinator in Access and Diversity at Weber State University, said, “We need more African-American healthcare providers and workers in general.” By the end of the discussion, a tangible need for greater diversity of healthcare providers and systems-based thinking was felt.

The following day, July 9, the Multicultural Commission held an off-site meeting at Weber State University to provide a public recap of the event. Lieutenant Governor Spencer J. Cox stressed the importance of creating community resource programs that focus on reaching the “individual.” With this, commission members reiterated the need for streamlined communication between community members and stakeholders.

Rebecca Chavez-Houck, Multicultural Commission member and former Utah House representative for District 24, asked that the community “notify the commission of what ‘boots on the ground’ issues there are”, which could then be addressed with broad policy. Nubia Peña, Director for the Utah Division of Multicultural Affairs, and Mikelle Moore of Intermountain Healthcare, confirmed that more open discussions and the building of community ties are within the next phase of this project which will take place in St. George. Residents and stakeholders are invited to learn more about the Utah Alliance for the Determinants of Health at Intermountain Healthcare’s website.

In light of these events, it has been made clear that considering the social determinants of health requires an intersectional approach as society does not function in isolation. The Utah Division of Multicultural Affairs, the Multicultural Commission, and Intermountain Healthcare will work together to continue this conversation in hopes that voices that typically go unheard, will be elevated and evaluated appropriately. Visit the Utah Division of Multicultural Affairs’ Facebook page for more updates on events surrounding this partnership and how you can get involved.