Social Determinants of Health

color silhouette of people links with community services

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 focuses on housing, transportation, food, and interpersonal violence/toxic stress in alignment with statewide priority domains. Trillium will also focus on employment, education, social integration, and community inclusion as an essential component of wellness and addressing unmet health-related resource needs.

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 unmet health-related resource needs. 

  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 affordable housing resources and resources for move-in costs. Neighborhood Connections Specialists will provide education on maintaining housing.
  • Trillium initiatives:
  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. 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.
  1. Interpersonal Violence/Toxic Stress: 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. Social Integration: Stigmas and public misperceptions can create isolation for those with behavioral health needs or Intellectual Developmental Disabilities. 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. 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 12% of those with a disability are unemployed (compared to about 6% for the general population, in February 2021), although they are proven to be strong, productive employees.

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