Jacqueline Whelan MN, RN, CNL’s Post

"Switching from "addressing social determinants" to "creating vital conditions" facilitates health equity and community health work in various ways. First, the goal of creating vital conditions is clearer and more accurate. It is more accurate because social determinants are not "determinant," as they do not automatically confer negative outcomes for those born into communities made marginalized. Additionally, this goal is clearer because of the ambiguity of "addressing" upstream factors. For example, health care often claims to address social determinants through efforts to screen patients for individual-level health-related social needs and to then refer them to local community services. Does a referral truly "address"? Does helping an individual patient secure safe, stable housing make a dent in the more upstream issue of a community's lack of humane, affordable housing? Conversely, ensuring all communities have breathable air or safe outdoor spaces are unambiguous goals, even if the path there is not uniform. In fact, that lack of a one-size-fits-all approach to the vital conditions is another strength: While the goal is inclusive and universal, achieving it is hyperlocal and allows for the kind of collaborative, multisector, context-dependent solutions that authentic community engagement seeks to produce." Thanks Philip M. Alberti for the thoughtful reflection in this article!