reveals poor and minority populations suffer a disproportionate burden of disease. The cause of these disparities is rooted not in biological differences, but in systematic social inequalities.2 Health inequities and the social determinants of health are priorities of public health improvement efforts at the global, national, and state level. The Rockbridge Area MAPP Project is aimed at promoting health equity at the local level. Health Equity: A Local Approach The concepts of health equity and social determinants of health have long been a part of global public health planning. At a 1978 International Conference on Primary Health Care, a commitment to health equity, and a call for multi-sectoral action was put into writing by the World Health Organization.3 Health is “a fundamental human right…the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.”
With Healthy People 2020, the United States made a formal commitment to social justice with an explicit acknowledgment of the role social and physical environments play in the health of populations.4
Healthy People 2020 states that health “starts in homes, schools, workplaces, and communities” and that the health of individuals is affected by: Access to health care Quality of education Safety of neighborhoods and workplaces Quality of food, air, water Nature of social relationships
2
World Health Organization, 2008, Final Report of the Commission on Social Determinants of Health, http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf 3 World Health Organization, 1978, Declaration of Alma-Ata, http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf 4 www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicd=39
4