Here’s how BUILD defines several key areas impacting community health.


Social Determinants of Health

The social determinants of health are all the environmental factors that influence your health, including early childhood development, employment opportunities, food insecurity, air and water quality, transportation, educational attainment, public safety, and housing.

Examples of social determinants that would impact your health include:

  • Is your home free of lead, mold, or other hazards?
  • Do you have access to affordable, nutritious food?
  • Do you have opportunities to exercise, either outside or at a exercise facility?

Income, education, housing, transportation, the built environment, and other “social” factors are the true “determinants” of your health – or as the Robert Wood Johnson Foundation (RWJF) has described it, “Where you live, work, learn, and play.” In collaboration with RWJF, the Virginia Commonwealth University has created life expectancy maps that illustrate the impact of the social determinants of health as you move through different neighborhoods of major US cities. We encourage you to also read this post on addressing social needs vs. social determinants of health and understanding the difference between the two.


Health Disparities

The BUILD Health Challenge defines health disparities as the differences in health outcomes based on race, ethnicity, sexual orientation, and socio-economic status. For example, minorities experience a higher prevalence of adverse health outcomes from chronic disease to mental illness to mortality rates than their white counterparts.

As a New York Times analysis declared in 2015, “Income Inequality: It’s Also Bad for Your Health.” The County Health Rankings & Roadmaps project also provides detailed breakdowns of county-by-county health disparities in data, maps, and more.


Health Equity

Health equity is achieved when immutable characteristics such as race, gender, sexual identity, and more are not correlated to higher rates of adverse health outcomes; i.e. that historically marginalized groups are no longer bearing a disproportionate burden of disease.

One of the goals of the BUILD Health Challenge is to promote health equity by creating the conditions to allow people to meet their optimal level of health.



An upstream approach addresses the community factors that shape health before any clinical intervention is necessary (also known as social determinants of health). These factors can include fields as diverse as affordable housing, public safety, access to healthy food and economic opportunity.

The de Beaumont Foundation’s Brian Castrucci discusses how public health ties into moving upstream to improve health and cut healthcare costs in the Huffington Post’s “Rowing Together: How Public Health Supports the ‘Upstream’ Doctor.”