It Takes a Village

Social Determinants of Health > Frameworks



Healthy People 2020 Framework

Healthy People 2020 is a project of the U.S. Department of Health and Human Services that provides science-based, 10-year national objectives for improving the health of all Americans. A foundational piece of their work is organized around measuring and addressing five areas of social determinants of health.

Healthy People 2020
This framework is explored further below.     The five minute video at the following link provides a clear and concise overview of their work and each of the five areas explored in this section of the E-Guide.

Social Determinants of Mental Health


The World Health Organization

The World Health Organization has reported that “A two-way relationship exists between mental disorders and socioeconomic status: mental disorders lead to reduced income and employment, which entrenches poverty and in turn increases the risk of mental disorder.” Key points that constitute components of this framework include:

  • Good mental health is integral to human health and well-being.
  • A person’s mental health and many common mental disorders are shaped by social, economic, and physical environments.
  • Populations are made vulnerable by deep-rooted poverty, social inequality and discrimination. Social arrangements and institutions, such as education, social care, and work have a huge impact on the opportunities that empower people to choose their own course in life.
  • Risk factors for many common mental disorders are heavily associated with social inequalities, whereby the greater the inequality the higher the inequality in risk.
  • In order to reduce these inequalities and reduce the incidence of mental disorders overall, it is vital that action is taken to improve the conditions of everyday life, beginning before birth and progressing into early childhood, older childhood and adolescence, during family building and working ages, and through to older age.
  • As mental disorders affect physical health these actions would also reduce inequalities in physical health and improve health overall.

A Public Health Approach to Understanding Mental Health

As knowledge has expanded throughout history we have moved from a “bad air” theory of health and mental health to 150 years of pendulum swings (nature versus nurture).

As we move into the 21st Century we are beginning to embrace an “and” approach to understanding health and mental health, which requires an understanding of the Social Determinants of Mental Health.

The following diagram illustrates the components of the social determinants of mental health.

social determinants of mental health

Exploring Healthy People 2020

Neighborhoods and Built Environments


Healthy People 2020 has identified four Neighborhood and Built Environment Determinants.

  • Access to Healthy Foods
  • Quality of Housing
  • Crime and Violence
  • Environmental Conditions

Neighborhood and Built Environment Objectives

Several Neighborhood and Built Environment Objectives have been identified, including:

AH-11.1: Reduce the rate of minor and young adult perpetration of violent crimes

AH-11.2: Reduce the rate of minor and young adult perpetration of serious property crimes

EH-1: Reduce the number of days the Air Quality Index (AQI) exceeds 100, weighted by population and AQI

IVP-29: Reduce homicides

IVP-33: Reduce physical assaults

IVP-42: Reduce children’s exposure to violence

Neighborhood and Built Environment Data Sets

The U.S. Centers for Disease Control and Prevention (CDC) has a rich source of data sets that support the Healthy People 2020 measures. The following example illustrates one of these measures– vacant housing.

Neighborhood and Built Environment Improvement Strategies

GTECH Strategies is an example of innovation in neighborhood development and vacant land use.

GTECH Strategies: Growth Through Energy and Community Health: Pittsburgh, PA

Colorado Health Foundation Re-Built is an example of a healthy places primer to build the future: