Addressing Social Determinants of Health: Community-Based Participatory Approaches to Research and Practice

Medical and public health research and practice in the second half of the 20th century primarily have focused on understanding and addressing individual risk factors for diseases such as smoking, dietary practices, and blood pressure. Despite the tremendous resources expended on these individual risk factors, disparities between the health of thosewho aremost advantaged and thosewith fewer economic and social privileges have continued and in some cases have increased. Residents of urban communitieswith high concentrations of poverty in particular suffer fromadisproportionate burden ofmorbidity andmortality. Finding effective means to understand, and more important, to intervene on, the factors that contribute to racial and socioeconomic disparities in health remains one of the most pressing problems facing public health professionals today. In this special issue ofHealth Education&Behavior, we examine efforts of the Urban ResearchCenters (URCs), as part of theUrbanHealth Initiative funded by theCenters for Disease Control and Prevention, to use community-based participatory approaches to understand and develop interventions to address social determinants of health (SDOH) in three urban communities: New York City, Detroit, and Seattle. Each of these sites has engaged in community-based participatory research and interventions to address SDOH from a somewhat different perspective. This special issue offers an opportunity to examine these approaches and to highlight their potential benefits and their challenges. In this introductory article, we first discuss a definition of social determinants and examine their role in racial and socioeconomic disparities in health, with a particular focus on urban health. Second, we discuss partnership approaches to research and practice and the particular role of such partnerships in research and interventions addressing SDOH.We particularly examine implications of inequalities in the social context as they