Health Education & Behavior, Vol. 31, No. 4, 455-471 (2004)

Social Determinants of Health: Implications for Environmental Health
Promotion
Amy Schulz, PhD, MPH
Department of Health Behavior and Health Education, University of Michigan,
School of Public Health, Ann Arbor.

Mary E. Northridge, PhD, MPH

Mailman School of Public Health, Columbia University, New York.

In this article, the authors draw on the disciplines of sociology and
environmental and social epidemiology to further understanding of
mechanisms through which social factors contribute to disparate
environmental exposures and health inequalities. They propose a conceptual
framework for environmental health promotion that considers dynamic social
processes through which social and environmental inequalities—and
associated health disparities—are produced, reproduced, and potentially
transformed. Using empirical evidence from the published literature, as
well as their own practical experiences in conducting community-based
participatory research in Detroit and Harlem, the authors examine health
promotion interventions at various levels (community-wide, regional, and
national) that aim to improve population health by addressing various
aspects of social processes and/or physical environments. Finally, they
recommend moving beyond environmental remediation strategies toward
environmental health promotion effor
ts that are sustainable and explicitly designed to reduce social,
environmental, and health inequalities.


Key Words: social determinants of health • health disparities •
environmental health promotion • health promotion interventions •
population health