Course Objective
- Explain the rationale for expanding public health practice to change living conditions to promote health and equity;
- Consider action on living conditions to be part of their scope of work;
- Identify some of the conceptual and organizational obstacles state and local health departments face in addressing living conditions;
- Explain how to apply the “upstream” strategies to define and achieve feasible goals in their own practice.
Date: August 8, 2016
Reviewed June 30, 2020
Presenter:
Nicholas Freudenberg
Distinguished Professor of Public Health
City University of New York School of Public Health
Emily Franzosa
Senior Researcher
City University of New York School of Public Health
The social determinants of health, or the structures and economic systems that shape patterns of wellness and illness, can be considered “upstream” that then influence downstream factors like obesity and teen pregnancy. Upstream factors are broad, deeply entrenched in our society, and can appear daunting to change. While public health often focuses on individual-level health behaviors, this approach requires a high level of effort from the targeted individual and has little influence on widespread population health. Health departments are increasingly moving upstream to tackle the core issues that affect the communities they serve. Income is one upstream factor that has a large impact on health and wellbeing. This module details how raising the minimum wage is a public health issue and provides a case study of one health department that used research, communication, and advocacy to influence an upstream factor of health.
