Lecture – Addressing Social Determinants of Health Through Community Coalitions

Presented by Sarah Coughlin, LICSW, LADC-1, National Association of Social Workers, Massachusetts Chapter – The Golda Edinburg Lecture

According to Sarah Coughlin, LICSW, LADC-1, only 20% of individual health needs are tied to actual clinical care. Physical environment, socioeconomic factors, personal behavior, and other social determinants account for the remaining 80%.

In this talk, Coughlin drills down into the social determinants of health care (SDOH). Drawing on studies, statistics, and her personal experience as a social worker in the Boston area, she shows that where a person comes from plays a larger role in determining health outcomes than who that person is.

The presentation is designed to help social workers and other participants understand the impact of these social determinants on health outcomes. Factors such as air and water quality, educational and employment opportunities, food insecurity, community safety, and racism are examined. Coughlin reinforces the idea that the quality of a person’s environment often determines the quality of life.

Presentation highlights include:

• A detailed look at the many social determinants of health, their impact on health outcomes, and the connection between health equity, social justice, racial justice, and SDOH
• An explanation of how partnerships between hospitals and communities can address SDOH
• A look at ways social workers and others can better assess the status and needs of patients and directly address issues caused by SDOH

Coughlin recounts stories from her career to illustrate the importance of the environment on individual patients. She also shows how community groups can help individuals cope with environmental stressors and tap into crucial resources to improve their health and well-being.

To show how community coalitions can help, Coughlin discusses the work of Charlestown Coalition, a community-based organization supported by the MGH Center for Community Health Improvement.

Coughlin explains how the coalition works with hospital and local leaders to create a healthy community. The group addresses a range of issues, including food insecurity, housing, violence and trauma, addiction, and more. The group’s successful model, Coughlin says, benefits both the hospital and the community.

Coughlin makes a strong case that community coalitions can help individuals lead better lives. If social workers focus on the environment rather than pathologizing the individual, she asserts, they can make a tremendous difference.

“It’s not about the goldfish,” she said. “It’s about the water.”