How healthy is Routt County? How do we promote health in the Yampa Valley? When we talk about health, what are we really talking about?

Ensuring our health involves more than scheduling annual exams and getting recommended immunizations. The foundation for lifelong health stems not as much from the individual steps we take each day but more from the ideology or culture in which we live. The foundation for health is rooted in our homes, families, schools and neighborhoods.

The World Health Organization refers to social determinants of health to acknowledge the conditions in which people are born, grow up, work, live and age as well as the wider set of forces and systems shaping conditions of daily life. The five key areas of social determinants are: neighborhood and built environment; health and health care; social and community context; economic stability; and education.

Everyone should have the opportunity to make choices that promote advantageous and sustainable living, regardless of income, education or ethnicity. Unfortunately, evidence shows that disadvantaged social circumstances are associated with increased health risks.

 For more than 30 years, Health Behavior in School-Age Children (HBSC) has collaborated with the World Health Organization to lead innovative international studies about the wellbeing, health behaviors and social contexts of youth. HBSC's findings shape policy to improve the lives of young people around the world.

HBSC has found that a family's socio-economic status is a potent predictor of young people's health. Costs restrict a family's ability to adopt healthy behaviors — eating fruits and vegetables or participating in fee-based physical activity. Young people in underprivileged homes are less likely to have access to adequate health resources and more likely to be exposed to psychosocial stress.

Building neighborhood social capital — marked by networks of relationships that foster reciprocity, trust and cooperation — combats health inequalities. Neighborhoods that generate high levels of social capital have better mental health, more health-promoting behaviors, fewer risk-taking behaviors, better perceptions of health and greater likelihood of physical activity.

When faced with health barriers related to income or socio-economics, HBSC encourages parents to establish open lines of communication with children. Communication with a protective entity helps children better navigate stressful situations and ward off negative threats.

Positive peer relationships are also critical for youth as they begin to form individual identities, develop social skills and self-esteem and establish personal autonomy. Similarly, school experiences guide youths' development of self-esteem, self-perception and health behavior.

According to HBSC, youth who perceive school to be supportive are more likely to engage in positive health behaviors and have better health outcomes, including high levels of life satisfaction, few health complaints and low prevalence of smoking.

Understanding the significance of social determinants, what can we do about them?

The Northwest Colorado Community Health Partnership is the lead agency for the Accountable Health Communities Model in the Yampa Valley. By examining how health-related social needs of Medicare and Medicaid recipients impact the overall health care system, the model addresses the gap between clinical care and community services.

The model consists of three major components: screening for social determinants at primary care visits, emergency room visits, and other visits; resource connections (enhanced 2-1-1 referrals); and community navigation.

Social determinants are influential elements of our health. Fortunately, we have powerful community partners, including LiftUp of Routt County, Yampa Valley Housing Authority, Northwest Colorado Center for Independence, Routt County Department of Human Services and Routt County United Way, which provide valuable programs and responsive services.

NCCHP is hosting "Let's Talk Health" from 5:30-7:30 p.m. Jan. 31 in partnership with Routt to Work at Bud Werner Memorial Library’s Library Hall. Arthur McFarlane, population health analyst and community outreach coordinator at Children's Hospital Colorado, will lead a conversation about social determinants.

Stephanie Monahan is the director of population health serving as the Regional Health Connector at Northwest Colorado Community Health Partnership. To learn more, visit ncchealthpartnership.org or call Monahan at 970-305-6398 or email smonahan@ncchealthpartnership.org.