Strategies: Structural Determinants of Health

Evidence-informed strategies to addresses the structural determinants of health. These solutions focus on building power and changing laws, policies, budgets and worldviews to improve the conditions that shape health.

37 Strategies

Good Samaritan drug overdose laws

Provide immunity from arrest, charges, or prosecution for drug possession or paraphernalia when individuals experiencing or witnessing drug overdose summon emergency services
Evidence Rating:
Expert Opinion

Community Conditions

  • Alcohol and drug use

Societal Rules

  • Laws and policies

School-based health centers

Provide health care services on school premises to attending elementary, middle, and high school students; physical and mental health services provided by teams of nurses, nurse practitioners, and physicians
Evidence Rating:
Scientifically Supported

Community Conditions

  • Education
  • Clinical care

Societal Rules

  • Institutional practices

Trauma-informed juvenile justice systems

Support a trauma-informed juvenile justice system to recognize and respond to trauma’s impact on youth through staff training and broad adoption of trauma-informed practices and policies
Evidence Rating:
Expert Opinion

Community Conditions

  • Safety and social support

Societal Rules

  • Institutional practices

Universal firearm background checks

Require both licensed firearm dealers and unlicensed (i.e., private) firearm sellers to conduct background checks of potential firearm purchasers; also known as comprehensive background checks
Evidence Rating:
Some Evidence

Community Conditions

  • Safety and social support

Societal Rules

  • Laws and policies

Land return for tribal restitution

Return the rights to land, property, and resources to Native people as part of policies and initiatives that promote tribal sovereignty
Evidence Rating:
Expert Opinion

Community Conditions

  • Income, employment and wealth
  • Civic and community resources

Societal Rules

  • Laws and policies

K-12 school finance reforms

Change state-level school finance systems to increase funding for school districts serving large populations of students from low income backgrounds, students of color, and students with disabilities, special needs, or limited English skills
Evidence Rating:
Scientifically Supported

Community Conditions

  • Education

Societal Rules

  • Laws and policies
  • Budgets

Youth civics education

Teach students attitudes, skills, knowledge, and behavior needed to participate in and contribute to a democracy
Evidence Rating:
Some Evidence

Community Conditions

  • Education
  • Civic and community resources

Societal Rules

  • Worldviews, culture and norms

Voter turnout initiatives

Increase voter turnout through get-out-the-vote campaigns and initiatives to make voting more convenient such as allowing early in-person voting, vote-by-mail, or expanding polling locations and hours
Evidence Rating:
Scientifically Supported

Community Conditions

  • Civic and community resources

Societal Rules

  • Governance

Voter registration initiatives

Increase the number of registered voters through initiatives that reduce barriers and expand accessibility, including automatic voter registration (AVR), voter registration drives, easing voter registration requirements, and expanding registration sites
Evidence Rating:
Scientifically Supported

Community Conditions

  • Civic and community resources

Societal Rules

  • Laws and policies
  • Governance

Labor unions

Organize workers to bargain collectively for improved wages, benefits, and working conditions
Evidence Rating:
Scientifically Supported

Community Conditions

  • Income, employment and wealth
  • Civic and community resources

Societal Rules

  • Institutional practices
  • Governance
  • Worldviews, culture and norms