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

BUILD defines health disparities as the differences in health outcomes based on race, ethnicity, sexual orientation and socio-economic status. One of the goals of the BUILD Health Challenge is to promote health equity, which requires moving upstream and creating conditions to allow people to meet their optimal level of health.


Health Equity

One of the goals of BUILD is to promote health equity by creating the conditions to allow people to meet their optimal level of health. BUILD defines health equity as “attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and social determinants of health — and to eliminate disparities in health and health care.” (Healthy People 2030)


Racial Justice

Race Forward defines racial justice as “the systemic fair treatment of people of all races, resulting in equitable opportunities and outcomes for all… [Racial justice] is not just the absence of discrimination and inequities, but also the presence of deliberate systems and supports to achieve and sustain racial equity through proactive and preventative measures.”

The Philanthropic Initiative for Racial Equity (PRE) shares a useful graphic for understanding the difference between utilizing a racial equity lens and utilizing a racial justice lens in their report, “Grantmaking with a Racial Justice Lens” (p.9).



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.”