Social Determinants of Health

Neighborhood connections

Wellness Where you Work, Play, and Live

According to the Centers for Disease Control and Prevention (CDC), social determinants of health (or SDoH) are “Conditions in the places where people live, learn, work, and play [that] affect a wide range of health risks and outcomes.”

Trillium will focus on transportation, employment, food, housing, and interpersonal safety. Trillium will also focus on the social integration and community inclusion. 

By managing Medicaid funding and services locally, Trillium achieved cost efficiencies that allowed us to reinvest savings in innovative programs and services that are making a difference in the communities we serve. These programs help address additional SDoH listed.

  1. Transportation: Only four municipalities (Wilmington, Greenville, Rocky Mount, and Jacksonville) operate regularly scheduled public transportation. One community (Ocracoke Island) can only be reached by ferry. Transportation is one of the top SDoH identified in our community; it impacts access to all services, regular employment, and participation in social activities. 


  1. Employment: Regular employment, whether full or part-time, helps provide income, a sense of purpose, and improves self-esteem. Data compiled by the U.S. Department of Labor Office of Disability Employment Policy shows that over 7% of those with a disability are unemployed (compared to about 3% for general population, in 2018), although they are proven to be strong, productive employees.


  1. Food: Nutrition is a basic, physiological need. Food insecurity makes it difficult to achieve any other goals. Food deserts (lack of grocery stores and fresh foods in a neighborhood) and food swamps (only food sources readily available are fast food restaurants or convenience stores) are common in both urban areas with lack of transportation and rural areas where it is miles to the nearest town.
  • Educational classes on healthy eating are a department focus.
  • Current Trillium Initiative


  1. Housing:  Success in treatment can be difficult when a person does not have decent, safe, and affordable housing.
    • Trillium Housing department partners with local housing authorities, property owners/managers, emergency shelters, and government officials to offer multiple housing options.
    • The Neighborhood Connections department will assist with locating resources for move-in costs and education on maintaining housing.


  1. Social Integration: Stigmas and public misperceptions can create isolation for those with behavioral health needs or IDD. Public sites and activities that encourage participation by people of all abilities help foster familiarity and awareness that there are more similarities than differences.


  1. Interpersonal Safety: Forty-seven percent of North Carolina women have experienced intimate partner violence and almost a quarter of North Carolina children have experienced adverse childhood experiences (ACEs). Experiencing trauma increases the likelihood of developing chronic health conditions.


  1. Other SDoH: