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

Housing reparations

Apologize for discriminatory housing policies; increase subsidies, financing, and paths to homeownership for people of color; and invest in systematically disadvantaged neighborhoods
Evidence Rating:
Expert Opinion

Community Conditions

  • Income, employment and wealth
  • Housing and transportation
  • Civic and community resources

Societal Rules

  • Laws and policies
  • Worldviews, culture and norms

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

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

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

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

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

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

Low Income Housing Tax Credits (LIHTCs)

Provide funding via tax credits at the state and local level to support development and rehabilitation costs of low income rental housing
Evidence Rating:
Some Evidence

Community Conditions

  • Housing and transportation

Societal Rules

  • Budgets

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

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