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\begin{document}

\title{Designing Health Care: A community health science solution for reducing
health disparities by integrating social determinants and the effects of
place}



\author[1]{Mark Dehaven}%
\author[2]{Nora  Gimpel}%
\author[3]{Heather  Kitzman-Carmichael}%
\author[4]{Daniel Gutierrez}%
\author[5]{Keri Revens}%
\affil[1]{University of North Carolina Charlotte College of Health and Human Services}%
\affil[2]{UT Southwestern Medical}%
\affil[3]{Baylor Scott and White Health}%
\affil[4]{William \& Mary}%
\affil[5]{Camino Community Center }%


\vspace{-1em}



  
  \date{May 04, 2024}


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\begin{abstract}
In the United States chronic illnesses have become a way of life for
multiple generations -- they are the number one cause of death and
disability (accounting for more than 70\% of deaths), 60\% of American
adults have at least one chronic disease, and 40\% have multiple chronic
conditions. Although multiple factors contribute to the growth in
chronic disease prevalence, a major factor has been overreliance on
health care systems for promoting health and preventing disease. Large
health care systems are ill equipped for this role since they are
designed to detect, treat, and manage disease, not to promote health or
address the underlying causes of disease.

Improving health outcomes in the U.S. will require implementing
broad-based prevention strategies combining biological, behavioral, and
societal variables that move beyond clinical care. According to
community medicine, clinical care alone cannot create, support, or
maintain health. Rather, health can only ensue from combining clinical
care with epidemiology and community organization, because health is a
social outcome resulting from a combination of clinical science,
collective responsibility, and informed social action. During the past
20 years, our team has developed an operational community medicine
approach known as community health science. Our model provides a simple
framework for integrating clinical care, population health, and
community organization, using community-based participatory research
(CBPR) practices for developing place-based initiatives. In the present
paper, we present a brief overview of the model and describe its
evolution, applications, and outcomes in two major urban environments.
The paper demonstrates means for integrating the social determinants of
health into collaborative place-based approaches, for aligning community
assets and reducing health disparities. We conclude by discussing how
asset-based community development can promote social connectivity and
improve health, and discuss how our approach reflects the emerging
national consensus on the importance of place-based population system
change.%
\end{abstract}%



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