The World Health Organization defines social determinants of health as the conditions in which people are born, grow, live, work, play, and age. These conditions are impacted by complex social structures and economic systems that shape these conditions. Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, social support networks, and access to health care and mental health services.

Social determinants of health are linked to a person’s opportunities and resources to protect, improve, and maintain his or her health.  Taken together, these factors are mostly responsible for health inequities—the unfair and avoidable differences in health status seen within and between populations. Therefore, addressing social determinants of health is critical for improving health and reducing health disparities (differences in health outcomes among groups of people).  These disparities are often rooted in social and economic disadvantages.

Health Inequities Related to HIV, STIs, and Hepatitis C

Social determinants of health contribute to infectious-disease-related health disparities that impact minoritized communities throughout the United States. In Iowa, for example, communities of color experience significantly higher rates of HIV and STIs than white Iowans. Contributing factors may include residential segregation, disproportionate incarceration rates, historical trauma, immigration and the complexity of issues many immigrant populations face, transportation, poverty, and stigma.

To achieve health equity, we must have an understanding of how these factors impact health. This section of the website features work that the Bureau of HIV, STI, and Hepatitis has completed to understand social determinants of health and their impact on Iowans impacted by HIV, chlamydia, gonorrhea, syphilis, and hepatitis C.

For more information on factors impacting disproportionate rates of HIV and STIs in communities of color in Iowa, see this presentation.

County-level Outbreak and Overdose Assessment

Iowa County-level Vulnerability Assessment for Risk of Opioid Overdose and Rapid Dissemination of HIV and Hepatitis C

This report summarizes the work of the Bureau of HIV, STI, and Hepatitis on the development of county-level vulnerability assessments for risk of opioid overdoses and rapid dissemination (i.e., outbreaks) of HIV and hepatitis C virus (HCV) infection. The analysis was completed in two parts as follows: 1) a vulnerability assessment for risk rapid dissemination of HIV and HCV infections; and 2) a vulnerability assessment for risk of opioid overdoses. This work was funded by a grant from the Centers for Disease Control and Prevention as part of the Opioid Prevention in States – Surge Support (OPIS – S2) Cooperative Agreement for Emergency Response.

Health Initiative for People Who Use Drugs (HIPWUD)

Iowa's Health Initiative for People Who Use Drugs (HIPWUD) is an advisory group comprising multi-sector professionals and people with lived experience. HIPWUD facilitates cross-sector engagement through a harm reduction lens to develop systems-focused strategies to address health and social services barriers for people who use drugs in Iowa with the goal to elevate and enhance the health and well-being of people who use drugs in Iowa. 

Contact Liz Sweet at with any questions.