ABSTRACT
This chapter explores the determinants of health based on place and position. Readers will review definitions of upstream, midstream, and downstream determinants of health and gain insight and direction for public health evaluation that incorporates SDOH. A review of the National Institute of Health’s three types of determinants helps contextualize determinants based on distribution of health outcomes within a population. These are distal, intermediate, and proximal determinants. This chapter also introduces the concept of justice and well-being, and dimensions of well-being that society must uphold for public health. Unique populations are also introduced and include Native American, American Indians or Alaska Natives, gender groups, Lesbian, Gay, Bisexual, and Transgender persons, veterans, and persons with disabilities. Places impact health and this chapter reviews urban, rural, and developing country health status and progress. Chapter 2 ends with five recommendations from researchers at the National Academy of Sciences. These recommendations, along with understanding stream conditions, will guide public health evaluators as they conceptualize evaluations using a SDOH lens.
