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

Firearm licensing laws

Require a potential purchaser to obtain a permit or license before purchasing a firearm
Evidence Rating:
Scientifically Supported

Community Conditions

  • Safety and social support

Societal Rules

  • Laws and policies

Minimum wage increases

Increase the lowest hourly, daily, or monthly compensation that employers may legally pay to workers
Evidence Rating:
Mixed Evidence

Community Conditions

  • Income, employment and wealth

Societal Rules

  • Laws and policies

Living wage laws

Establish locally mandated wages that are higher than state or federal minimum wage levels
Evidence Rating:
Some Evidence

Community Conditions

  • Income, employment and wealth

Societal Rules

  • Laws and policies

Paid family leave

Provide employees with paid time off for circumstances such as a recent birth or adoption, a parent or spouse with a serious medical condition, or a sick child
Evidence Rating:
Scientifically Supported

Community Conditions

  • Income, employment and wealth

Societal Rules

  • Institutional practices
  • Laws and policies

Child care subsidies

Provide financial assistance to working parents, or parents attending school, to pay for child care
Evidence Rating:
Scientifically Supported

Community Conditions

  • Income, employment and wealth

Societal Rules

  • Budgets

School nutrition standards

Regulate the quality of food that can be sold to students through the National School Lunch Program (NSLP), à la carte options, vending machines, etc.
Evidence Rating:
Scientifically Supported

Community Conditions

  • Diet and exercise
  • Climate

Societal Rules

  • Laws and policies

Zoning regulation and land use policy reforms

Reform zoning regulations to remove exclusionary zoning codes, address physical environment aesthetics and safety, street continuity and connectivity, residential density, and mixed-use development, etc.
Evidence Rating:
Scientifically Supported

Community Conditions

  • Housing and transportation
  • Diet and exercise
  • Air, water and land
  • Climate

Societal Rules

  • Laws and policies

Inclusionary zoning & housing policies

Require developers to reserve a proportion of housing units for residents with low incomes via mandatory requirements or incentives, such as density bonuses
Evidence Rating:
Some Evidence

Community Conditions

  • Housing and transportation
  • Air, water and land
  • Civic and community resources

Societal Rules

  • Laws and policies

Land banking

Acquire, hold, manage, and develop properties such as vacant lots, abandoned buildings, or foreclosures, and transition them to productive uses, often affordable housing developments
Evidence Rating:
Some Evidence

Community Conditions

  • Housing and transportation
  • Air, water and land
  • Civic and community resources

Societal Rules

  • Institutional practices

Community land trusts

Purchase the land a home is on to lease to homeowners with low and middle incomes and require homeowners to sell the home back to the trust or to another resident with low income upon moving
Evidence Rating:
Some Evidence

Community Conditions

  • Housing and transportation
  • Air, water and land
  • Civic and community resources

Societal Rules

  • Institutional practices