[MUSIC] Hello, my name is Rachel Thornton, I'm an Assistant Professor of pediatrics in the Johns Hopkins School of Medicine, and the Associate Director for Policy for the Center of Health Equity. Today I'm going to be talking to you about engaging policy stakeholders to address social determinants of health disparities. I have no financial disclosures to report. So how do we define social determinants of health? What are they? The social determinants of health are the conditions in which people live, learn, work, play and worship. The conditions which people live their lives. How do they impact health exactly? We often think of the impact of social determinants coming through exposure to poverty, access to quality education, healthy housing conditions and neighborhood conditions. For example, living in a segregated resource deprived neighborhood can produce disparities in health for the residents of those communities. What are the long term impacts of the social determinants of health? We know that exposures to deleterious conditions during the life course in childhood can have long term impacts on the health well being and development of people. So it's not just that the exposure to a specific type of neighborhood condition or housing condition or social economic conditions affects our health in the short term, but in fact those exposures early in life can manifest in health disparities and adulthood. Furthermore, they can accumulate over time, so that at every point in life that a person is exposed to positive or negative conditions, it can impact their health trajectory. I like to discuss the social determinants of health using a picture that helps us imagine how conditions might affect health. And not just health outcomes but also the behavioral choices that people make, which ultimately impact health. As a pediatrician, I take care of children and families who live in a variety of neighborhoods. Now you can imagine that a parent raising a child in the neighborhood pictured on your left would have a different set of concerns around outdoor physical activity for example, than a parent raising a child living in the neighborhood pictured on your right. For example, a parent and the neighborhood on the left, could consider that despite the fact that they know that being active outdoors is healthy and helps children prevent obesity, there are a variety of other dangers that the child might face playing outdoors in that neighborhood. So they make a different set of decisions around health promoting behaviors for their child, then someone who's living in a neighborhood similar to that pictured on the right, where the dangers of playing outside are less apparent and the benefits are more obvious. [MUSIC]