A new framework
for mitigating harmful SDOH
The DUSON/CLAFH framework serves as a roadmap for educators, practitioners, researchers, policymakers and other stakeholders designing programs to mitigate harmful SDOH and bolster strength-based resilience factors that set communities up to thrive despite structural adversity.
Health inequity: A systematic, unfair, and avoidable health difference between segments of the population.
Social determinants of health: The conditions in which people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life and health outcomes.
Social determinants of health capital: Socially allotted resources and opportunities that affect health outcomes (e.g., income, educational attainment, quality of housing, accessibility and quality of available healthcare, etc.).
Social determinants of health processes: Social factors shaping the interactions between persons, groups, institutions, commercial interests or systems that affect health outcomes (e.g., policies, business practices, norms, racism, sexism, classism, xenophobia, homophobia, etc.).
Exposure: The subjection to a health risk or protective factor (exposure is environmental or behavioral).
Susceptibility: The likelihood of morbidity/mortality given the exposure to a health risk factor (susceptibility is biological).
Resilience: The factors that enable individuals, institutions, or communities/populations to thrive in the context of adversity.
Family Context: The family represents a primary context where the depicted SDOH mechanisms manifest, and where opportunities for mitigation exist.
Micro, Meso, Macro: Each of the depicted constructs and relationships can be conceptualized as micro (individual level), meso (institutional level), and macro (structural level) influences, or a combination thereof.
Life Course: The impact of the depicted SDOH mechanisms is cumulative over the course of an individual’s life.
