Extension's National Framework for Health Equity


This updated framework continues to reinforce the notion that individuals live, learn, work, and play within a social system. The relationship between an individual and the social system in which they live is frequently depicted through a social-ecological model. In general, such models show how the daily lives of individuals are nested within and influenced by interpersonal relationships, families, schools, workplaces, communities, and societal norms and values. F actors outside of the individual that have an influence on an individual’s health are known as the social determinants of health (SDoH).

Contemporary Population Health Frameworks

Contemporary population health frameworks draw from a growing, and well documented body of literature illustrating the multiple determinants of health extending beyond individual behaviors and health care. There are also numerous models for grouping the many determinants of health into distinct categories. For example, The National Academies (2017) identify education, employment, transportation, social environment, public safety, physical environment, housing, wealth, and health systems as nine areas upon which systems change can focus. Healthy People 2030 groups determinants into health care access and quality, education access and quality, neighborhood and built environment, social and community context, and economic stability. Community Commons (2020) suggests that meaningful work and wealth, basic needs for health and safety, belonging and civic muscle, lifelong learning, humane housing, reliable transportation,


“An Introduction to Social Determinants of Health. This 6-minute video, produced by Ranil Appuhamy, explores the topic. It is part of a video series entitled “Let’s Learn Public Health.”

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Social Determinants of Health

The Vision for a Well-Being Economy


Why the Future Economy has to be a Wellbeing Economy. This 15-minute video features’s Katherine Trebeck’s TEDx Talk.

and a thriving natural world are the vital conditions necessary for intergenerational well-being. The County Health Rankings Model emphasizes the factors that determine how long and how well people live.

Strengthening Extension’s Capacity to Engage

As mentioned earlier, the 2014 Framework recognized the powerful influence of the social determinants of health but stopped short of advocating that Extension engage in efforts to address them and instead identified six broad areas of educational programming that should be emphasized. The updated framework supports the positions of authors who suggest that work to promote the adoption of healthy behaviors across the general population must continue (Koukel et al, 2018) but also suggests that Extension must continually strengthen its capacity to support PSE changes for individuals and communities experiencing


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