Changing Risk Behaviors

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The Sociocultural Environment and
Health Systematic Reviews of Community
Interventions

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Sociocultural Review Team
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A Tool for Informed Decision-Making
The Community Guide provides a set of
evidence-based recommendations for public health
action to improve community health. The
Community Guide summarizes what is known about
the effectiveness and feasibility of
community-based health interventions by
conducting systematic reviews of the intervention
literature.
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Community Guide Reviews
www.thecommunityguide.org
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Community Interventions to Promote
Health-Enhancing Social Environments
The sociocultural environment exerts a
fundamental influence on health at the
neighborhood, community, and societal level. The
Sociocultural Environment reviews in the Guide
will include evaluations and recommendations on
interventions to reduce health inequalities
through modifying the social environment.
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SOCIOCULTURAL DETERMINANTS SOCIAL RESOURCES
AND THEIR DISTRIBUTION IMPACT HEALTH
Social Resources Standard of living Culture and
history Social institutions Built
environments Political structures Economic
systems Technology
Equity Social Justice
(Resource Distribution)
COMMUNITY HEALTH

• Physical
• Environment

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Social Resources and their Distribution
Adequate social resources are prerequisite to
maintaining a supportive social environment for
health. Equity and social justice are
quintessential to health. They are conditions
that characterize the distribution of resources
among the population.
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I N T E R M E D I A T E O U T C O M E S
OUTCOME
COMMUNITY HEALTH
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Intermediate Outcomes
Between root social determinants and health
outcomes are observable community conditions
amenable to intervention programs neighborhood
living conditions, school and work opportunities,
community norms, neighborhood cohesion,
available health and social services These are
quantifiable conditions and thus offer a means to
account for why communities with few social
resources experience poorer health.
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SOCIOCULTURAL ENVIRONMENT FRAMEWORK
Intermediate Outcomes
Determinants
EQUITY AND
Neighborhood Living Conditions
SOCIAL
JUSTICE
Community Development
and Employment Opportunities
SOCIAL RESOURCES
Standard of living Culture and history Social
institutions Built environments Political
structures Economic systems Technology
Civic Engagement Participation
Health Outcome
in Decision-Making
HEALTHIER COMMUNITIES
Community Customs,

Norms and Processes
Opportunities for Learning and
Developing Capacity
PHYSICAL
ENVIRONMENT
Natural Resources
Health Promotion, Prevention

and Care Opportunities
.
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Priority Interventions for Health Enhancing
Social Environments

• RANKED BY POTENTIAL IMPACT ON IMPROVING COMMUNITY
  HEALTH
• Child development programs (Head Start, Healthy
  Start, etc.).
• Adequate public investment in education.
• Living wages to move working families above
  poverty.
• Access to quality health care for all ages.
• Mixed income housing to decrease segregation by
  socioeconomic status.
• Programs to reintegrate stigmatized populations.
• Parenting classes in schools, churches, health
  agencies, etc.
• Neighborhood schools as site of numerous
  community support programs.
• Family-focused, one-stop health and human
  services centers.
• Adequate health benefits with employment.

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Completed Systematic Reviews
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Early Childhood Development Programs
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Affordable Housing in Mixed-SES Neighborhoods
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Access to Culturally Competent Health Care

• Access to culturally competent health care
• Diversity training
• Culturally accommodating settings
• Interpreter services
• Culturally appropriate health education materials
• Diverse staffing
• Insufficient number of evaluation studies to draw
  conclusions about intervention effectiveness

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For Further Information

• Morbidity and Mortality Weekly Report on
  Community Guide Sociocultural Environment reviews
  coming in November 2001
• Reviews will be published in the American Journal
  of Preventive Medicine in Fall 2002
• Community Guide website www.thecommunityguide.org