The “Mechanisms” that Link a Social Determinant of Health to Adverse Health Outcomes: Reaction Paper

The part of the reading that caught my attention regarding the “mechanisms” that link the social determinants of health-to-health disparities is Barr’s claim that the problem has little to do with the healthcare system and more with the individual’s position in the social hierarchy. The section motivated me to look deeper into our society to understand why some people suffer more from lifestyle diseases like cardiovascular conditions.

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The “mechanisms” that link a social determinant of health to adverse health outcomes, such as high rates of cardiovascular conditions, is income. Structural inequities are created by interpersonal, institutional, and systemic biases that sort people along with their income level. They place members in resource-rich or resource-poor neighborhoods (Baciu et al., 2017). One of the health outcomes of such a mechanism includes higher rates of cardiovascular conditions due to intake of poor diets and lack of access to quality care checkups due to lack of resources among those in resource-poor neighborhoods.

When reading the section, I felt sorry and angry at the same time. I felt angry about the government and other policymakers for failing to create policies to address the disparities. I felt sorry for the people who lack access to healthy meals and quality access to preventive care and treatment simply due to biases that create disparaging policies and practices.

Public Health community-level interventions can help to address the problems associated with income to improve health outcomes. Community empowerment targeting resource-poor neighborhoods could help create awareness of the need for preventive care and timely treatment. Community leaders should also educate them regarding economic empowerment to improve their income and reduce the gap between the social classes.


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Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., & National Academies of Sciences, Engineering, and Medicine. (2017). The state of health disparities in the United States. In Communities in action: Pathways to health equity. National Academies Press (US).

Barr, D. A. (2014). Health Disparities in the United States: Social Class, Race, Ethnicity, and Health. Baltimore: Johns Hopkins Press.

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