Social Determinants of Health

Posted: July 3, 2018
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Social Determinants of Health (SDoH)

LAPTN Community Resources Database
NextGen PRAPARE Data Documentation and Codification Crosswalk
SNI SDOH Resource Landscape

SDoH Clinical Operations Resources

Aunt Bertha Toolkit for Community Resources
Aunt Bertha CBO Cheat Sheet
Aunt Bertha CBO Training 2020
Aunt Bertha Fact Sheet

211 San Diego CIE Toolkit
FRAC Federal Nutrition Programs
FRAC Prescription for Healthy Food
LACHC Care Coordinator Job Description
Maximize CalFresh Benefits with the Standard Medical Deduction
NEVHC Pop-Up Produce Market Waiver
NOPREN Food Insecurity Screening Algorithm for Pediatric Patients
NEVHC PRAPARE Tool Cheat Sheet
PRAPARE Tool

SDoH Research and Reports

Exploring the Feasibility of Implementing Healthy Food Pantries in LA
Food Recovery and Distribution in LA
Health Equity Messaging Guide

Food Insecurity Resources

Nutrition Access LA Resources
Food Assistance Programs and Food Resources

Food Pantries by Service Planning Area (SPA)
SPA1 Food Pantries
SPA2 Food Pantries
SPA3 Food Pantries
SPA4 Food Pantries
SPA5 Food Pantries
SPA6 Food Pantries
SPA7 Food Pantries
SPA8 Food Pantries

Transportation Resources

Clinic Templates
NEMS Patient Needs Assessment
OCH Patient Transportation Survey
VCC Transportation Questionnaire

LA Metro Low Income Fare is Easy (LIFE) Program and Transit Access Pass (TAP) Resources
Transit Access Pass
TAP Vendor Flyer
TAP Agency Application
TAP Token Alternatives Flyer
TAP Publication LIFE Directory
TAP Metro Fare Products

Socio-economic and environmental factors play a significant role in a person’s ability to achieve health and wellness. The following section highlights the social determinants of health impacting Angelenos. 

Data from the annual counts of homeless persons in the County shows a 37.9% increase from 2013 to 2017 from 35,524 to 57,205, respectively.


Source: LAHSA 2013 and 2017 Homeless Counts

The number of community clinic patients that lived below 100% federal poverty level increased in SPAs 1, 3, 5, and 7.


Source: OSHPD 2012 and 2015

Through a variety of measures of health, Los Angeles County and the SPAs have wide variation in health indicators.  Many of the indicators are directly impacted by economic and social conditions, and can be mitigated by access to health care. With the exception of a few SPAs, most areas are impacted by high poverty rates, high rates low educational attainment, and high rates of the population who spend more than 30% of income for housing.  These indicators show there are significant proportions of the County’s populations that are living in extreme economic hardship.


Source: CHIS 2012 and 2015

These are key findings from CCALAC’s 2018 Network Adequacy Report.

This project was funded by L.A. Care Health Plan to benefit low-income and uninsured residents of Los Angeles County.