Social Determinants of Health: Learn from an Expert

A Q&A with County Commissioner Katherlyn Geter

What we do together today...

...determines how we LIVE UNITED tomorrow.

Social Determinants of Health (SDOH) are factors external to a person’s physical state of well-being, like their physical and built environment, access to healthy food, etc., that have a significant impact on short- and long-term health outcomes. You can find an in-depth definition and explanation, as well as a breakdown of key areas and issues, here.  


We recently spoke with Katherlyn Geter, County Commissioner and community advocate, to learn more about the social determinants of health, her work around the issues and how every member of our community can get involved. Read on to learn more from an expert!


Q: Can you tell us about your work with Social Determinants of Health?  

I have worked in social services and healthcare for over 20 years. I’ve worked with both rural and urban populations as I have seen and assisted individuals throughout the Southeast Region. In my work in helping individuals understand community services and health insurance (including Medicare, Medicaid/TennCare, and the Federal Insurance Marketplace), I have witnessed the realities of SHOH that individuals and families are facing -- realities like unhealthy environments, poor access to education, food insecurity, community and family violence and more. Through my work, I’ve partnered with various faith-based organizations and both private and public sector organizations.


Currently, I am the Executive Director of a local non-profit called Purpose Point Community Resource Center (PPCRC), which is the non-profit arm of the Mt. Canaan Baptist Church. PPCRC works with individuals and families to provide high-quality early childhood education and promote the development of healthier communities. We have just opened Purpose Point Community Health (PPCH), which focuses on health and wellness in the heart of East Chattanooga. 


PPCH’s purpose is to promote the development of healthier communities by providing physical, spiritual and emotional care. We are a comprehensive center that addresses and provides care in the following:

  1. Physical – primary medical care to uninsured adults 18 and older 

  2. Emotional – care coordination and community navigation. The role of care coordination is key because of the existence of social inequalities within our communities and the growing complexities of our healthcare system. We know it’s important for us to holistically address both the medical and social needs.

  3. Health and wellness – community garden, exercise classes, education classes, etc.


Q: Which key issue (or issues) within the SDOH is most prevalent in Greater Chattanooga?

This question is hard to answer because in reality, ALL of the issues are prevalent depending upon the person I’m speaking with and the crisis they face and on which zip code I’m in. It’s difficult to determine which issue is MOST prevalent.


As a Commissioner and advocate who has worked in the community for many years, the SDOH issues that I continue to see repeatedly include the following:

  • Education

  • Food

  • Access to health care

  • Neighborhood and physical environment

 For reference, here’s a chart to help conceptualize the SDOH key areas and issues. 

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Q: How do you see SDOH affecting the everyday lives of our neighbors? 

The SDOH affect the everyday lives of our neighbors in a big way. In my opinion, it’s not a conversation about what we are seeing, but rather the lens we are choosing to see through -- the SDOH are very complex, macro-sized issues that can be easily identified within our communities (see the chart above). However, the challenges around SDOH and the impact they have on our neighbors are micro-sized and specific to individuals. So again, it’s about not what we are seeing (what happened), but how we are choosing to see it (what’s wrong). For example, imagine a student here in our school district(s) who is struggling to stay awake in class. One may view this situation at a surface level and understand it only for what happened -- that the student fell asleep in class. But the impact of the SDOH means that behind the scenes, it’s possible the student hasn’t eaten and is hungry, and is therefore struggling to focus in class and earn passing grades. If we choose to look with a different lens and ask what’s wrong beneath the surface, we begin to see the true impact of SDOH on this student. In reality, the student may come from a single family household with their father in prison and their mother struggling with drugs, have two other siblings at home, live in a community with high levels of crime and violence and deal with a host of SDOH-related issues.


The impact that SDOH has on a person is part of their everyday existence. As another example, consider transportation -- not just the availability of transportation, but the accessibility of transportation. Degree of access to transportation greatly affects an individual’s ability to access employment, purchase healthy foods and afford healthcare.   


Until we are willing to ask the hard question -- to ask “what’s wrong?” instead of stopping with “what happened?” -- we won’t fully understand the impact that the SDOH are having on our neighbors.


Q: How do you see SDOH affecting the long-term health outcomes of our neighbors? 

I believe we must consider this question with a broader lens and a holistic mindset -- one that not only looks at physical health, but includes ways to be intentional in addressing and considering the implications of SDOH. Addressing the SDOH is crucial for improving the health and overall wellbeing of both individuals and entire communities by reducing long standing health disparities. Our health is driven by lots of things: our DNA, the things we choose to do to our bodies, our healthcare system and environments. All these factors contribute to health outcomes.


Q: When it comes to SDOH in our community, where are the biggest needs? 

I believe the biggest needs are related to issues around access. The problems are not concerned with a lack of availability of resources here in Greater Chattanooga. The gaps in access to these resources hinge on who you are, the zip code you reside in, etc. Resource access is the biggest challenge facing most individuals. More engaging, community care-focused models of messaging and aid that are designed to meet individuals where they are to help address the complex SDOH issues and health disparities are greatly needed.


Food deserts (areas with limited access to food resources) are another pressing issue and exist within many of our communities -- and the COVID-19 pandemic has only heightened this issue. Food deserts are not just indicators of socioeconomic status in an area, but are indicators of public health issues and safety concerns.


So again, this is a hard question to answer -- when it comes to SDOH, there is no single need that is biggest. In many of our neighborhoods, all of the SDOH issues are “biggest,” but issues with access to resources are consistent across the community.


Q: What can I do to help improve SDOH issues for my neighbors? 

We ALL have a role to play in improving SDOH issues for our neighbors. In my own work to address SDOH issues, I keep three motivating themes in mind:

  1. Be INTENTIONAL – keep it real. Facing the inequities and challenges embedded within the SDOH is difficult. However, if we are to truly roll up our sleeves and address these issues, the work requires us to be open and honest and to build a foundation of trust with those we serve.

  2. COMMUNITY – community is everything! In order for these macro-sized issues around SDOH to improve, everyone in the community must be engaged in every aspect of this work. The solution begins with the lens you choose to view a person through. The next time you see, hear or read a hard story about a neighbor’s situation, don’t ask “what happened” -- ask “what’s wrong?” Go deeper and consider the hard questions. Travel to new zip codes to volunteer and get to know your fellow community members. Connect with a non-profit organization that is helping individuals and families here in Greater Chattanooga to learn more about how you can get involved. 

  3. And lastly, PARTNERSHIPS – to improve issues around SDOH, we need to check our individualistic mindset at the door. All stakeholders from the government, faith, public and private sectors must come together to create systems, policies and communities that enable all people to attain and sustain good health and wellbeing. The issues are too big for us to address by staying in our own neighborhoods and businesses, our own worlds, only to look out the window and say, “yep, I see there are lots of problems out there.” This work requires us to PARTNER with others that don’t look or think like us and live in different zip codes. It requires us to open the door, step outside and cross the street to lock arms with our neighbors. That’s how we improve and build community. 


Katherlyn is a Greater Chattanooga change-maker and is looking for solutions to root issue problems, rather than what rests at the surface. “Until we are willing to ask the hard question -- to ask “what’s wrong?” instead of stopping with “what happened?” -- we won’t fully understand the impact that the SDOH are having on our neighbors.” 

This is what Living United looks like, and is what we all must aspire to in order to serve those in greatest need. You can start that journey today by Giving, Advocating and Volunteering to address the root issues that threaten the youth and childhood success, financial stability and healthy outcomes of our neighbors.

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