Week 2: Socioecological Models

What is the Socioecological model?

Examines how individual, interpersonal, community, and societal factors shape health (interplay of internal + externlal)

Used to design interventions that don’t over-blame individuals—target SDOH

Key idea for social ecological framework

Health is shaped by multiple layers of influence

What is the history of the Socioecological model?

Based on Bronfenbrenner’s Ecological Systems Theory

—emerge as response to need for multi-level approaches

What are the core constructs (levels)of the Socioecological model?

Levels of factors

1) Intrapersonal/Individual

2) Interpersonal

3) Institutional

4) Community

5) Societal/ Public Policy

What is the intrapersonal/individual level

The foundation for explaining health promotion

=knowledge, attitudes, beliefs, personality traits, skills, perceptions

What is the interpersonal level

external factors in relationships with peers—social identity

—friends, family, social networks

What is the institutional level

Organizations, schools, workplace

What is the community level

Cities, neighborhoods, resources, norms

What is the policy level

Federal, state, local legislation

—intervention at this level changes things on large scale (nationwide)

What are the social determinants of health

Non-medical factors that influence health outcomes—conditions we’re born, live, work, age

=socioeconomic factors, physical environment

Examples of social determinants of health

Economic stability

Education access

Health care access

neighborhood, built environment

Social + community context

Why use the Socioecoloical model?

Encourages systems thinking

Combines individual and structural approaches for change

identifies interventions at multiple levels

What is the Health Impact Pyramid

Framework to understand the population-level impact of ph interventions

—Interventions lower=more broad, help more, less ind effort

What is the history of the HIP

Created by Thomas Frieden, former CDC director

What are the levels of the HIP

1) Socioeconomic factors

2) Changing the context to make healthy decision the default

3) Long-lasting protective interventions

4) Clinical interventions

5) Counseling

Examples of socio-economic factors (HIP)

antipoverty, education, access to healthcare

Examples of “changing the context” interventions

Smoke-free laws, lead paint ban, tobacco/soda tax, 0g trans fat

Examples of long-lasting protective interventions

Immunizations, smoking cessation, colonoscopy

What are examples of clinical interventions

control blood sugar, cholesterol, diabetes

Examples of counseling + education interventions

health education on nutrition, physical activity

Why use the HIP?

Focus on social determinants of health

Tiered structure that portrays individual-based interventions=less impact

Guides policy decisions to focus on intervention with most impact

How are SEM and HIP similar

Both emphasize multi-level approaches, structural changes

Both recognize socioeconomic political components

Differences

SEM: focus on interactions between levels, determinants

HIP: focus on intervention impact