Welcome to the National Action Agenda
to Advance Upstream Social Determinants and Health Equity

Stewards of Change Institute
, the Stanford University Center for Population Health Sciences and additional organizational collaborators across the country created a National Action Agenda to Advance Upstream Social Determinants and Health Equity. The initiative’s intent was to instigate and implement tangible, systems-level change across Health, Human Services, Education, Public Health, Public Safety and other domains.

The Equity Action Agenda encompassed a coordinated set of ambitious activities throughout this year and beyond, all of which were designed to significantly accelerate progress through cross-sector data-sharing, interoperability and collaboration. We strongly believed that doing so would:

  • Enable a more-effective response to health crises such as Covid-19; 
  • Broadly, systemically advance holistic, person-centered care; and
  • Significantly contribute to furthering health equity and social justice.

* Important: Six workgroup teams helped shape the National Action Agenda, each focused on a different Social Determinant: Community & Social ContextEconomic MobilityEducationHealth Care & Behavioral Health SystemLegal, and Neighborhood & Physical Environment

National Action Agenda Symposium to Advance Upstream Social Determinants and Health Equity

The National Action Agenda Symposium was held on January 25-26, 2021. Its focus included the six action recommendations devised by subject matter experts nationwide during the past year, along with a preview of how work will begin at our first implementation site in the months ahead.

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Action Recommendations
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About the SDOH National Action Agenda

Why NOW?

We have initiated the action steps in this unique effort because:

  • A national agenda focused on the Social Determinants of Health and Well-Being (particularly on “upstream” activities in communities nationwide) is long overdue. It should be a critical component of post-coronavirus rebuilding activities.
  • Covid-19 has had a broad and deep impact throughout society, contributing to troubling public health, economic and social problems. Pointedly, the people most negatively impacted are those who already were underserved and under-resourced.
  • The need to work more explicitly for equity, in health and more broadly, is clear. Interoperability is a critical way to pursue that goal by routinely providing the data needed both to understand the impact of racial/socioeconomic disparities and to address them.
  • This is a historic opportunity to make fundamental, generational changes that will help to drive progress in many concrete ways.

Learn more about the action agenda >>

Action Agenda Timeline

  • Webinar Launch of National Action Agenda (August 14, 2020)
  • Form 6 Social Determinants of Health Workgroups (Late August 2020)
  • Workgroup Leaders/Co-Leaders Kick-Off Meeting (September 25, 2020)
  • Monthly Workgroup Sessions (September 2020 – January 2021)
  • Monthly Cross-Group Synthesis Meetings (September 2020 – January 2021)
  • Produce Drafts of “The Social Determinants: A Call to Action for Making Tangible Progress” for ongoing comment and refinement; to be used to help shape agenda for the national symposium (Q2, Q3, Q4 2020)
  • Stewards of Change Institute Virtual Convening (January 25-26, 2021)
  • Finalize “The Social Determinants: A Call to Action for Making Tangible Progress,” as a product of the Symposium and workgroups (April 2021)
  • Begin implementation (April 2021)


  Featured Resources

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 Featured Webinars

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Leadership Team & Advisors


Core AA members

  • Karen Smith, M.D., M.P.H., (former) Director of California Department of Public Health
  • Pierre-Gerlier Forest, PhD, Professor and Director, James S. and Barbara A. Palmer Chair in Public Policy, School of Public Policy, University of Calgary
  • David H. Rehkopf, ScD, MPH, Associate Professor of Medicine (Primary Care and Population Health) and, by courtesy, of Health Research and Policy (Epidemiology); Co-director of the Stanford University Center for Population Health Sciences
  • Lesley Sept, Executive Director of Population Health Sciences, VPHS-Population Health Sciences
  • Daniel Stein, MBA, President, Stewards of Change Institute

Synthesis Advisors

  • David Aylward, JD, Assistant Clinical Professor of Family Medicine, University of Colorado School of Medicine
  • Alina Baciu, PhD, MPD, Senior Program Officer, National Academy of Sciences
  • Dan Chavez, Executive Director, San Diego Health Connect
  • Toby Ewing, Executive Director, CA Mental Health Services Oversight and Accountability Commission (MHSOAC)
  • Caroline Fichtenberg, Managing Director, Social Interventions Research and Evaluation Network (SIREN), UCSF Center for Health and Community
  • Stacy Shwartz Olagundoye, MS, Program Manager, California Alliance of Child and Family Services, The Catalyst Center
  • Michael Wilkening, Special Advisor or Innovation & Digital Services, Office of Governor Gavin Newsom (CA)


  • Evelyn Gallego, MBA, MPH, CPHIMS, Found & CEO at EMI Advisors, LLC, SIREN/HL7 Gravity Project Program Manager at Health Level Seven International (HL7)
  • Ryan Howells, Principal, Leavitt Partners
  • Nick Macchione, Agency Director and Deputy Chief Administrative Officer, San Diego Department of Health and Human Services
  • Kshemendra Paul, Chief Data Officer at U.S. Department of Veterans Affairs, Mission and Strategy Cloud Action Officer & Deputy Director at Department of Homeland Security
  • David Ross, ScD, President & CEO, The Task Force for Global Health Inc., (former) Director of the Public Health Informatics Institute
  • Ken Kaplan, MSW, MARCH/HP, Founding Partner, Health Community Ventures, Inc.
  • Uma Ahluwalia, Managing Principal, Health Management Associates




California enacted the State Leadership Accountability Act (SLAA) requires all state agencies to monitor their internal control systems to minimize fraud, errors, waste, and abuse of government funds.  Is there a way to lobby for a national version of this process to spur integration and blending of funding? Here is the latest updates: SLAA Reports

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Engaging Those That Matter

Building Healthy Communities is an  is a 10 year, $1 billion comprehensive community initiative launched by The California Endowment in 2010 to advance statewide policy, change the narrative, and transform 14 of California’s communities devastated by health inequities into places where all people and neighborhoods thrive.It's cycle is winding down, and transforming into a new direction.  What can we learn from their efforts on engaging at risk groups and those with lived experience? 

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Examples: Building on Integration and 211

Are you aware of any statewide resources that are making strides forward to share resourcesa nd integrate?  Here is an example:NCCARE360NCCARE360 is the first statewide network that unites health care and human services organizations with a shared technology that enables a coordinated, community-oriented, person-centered approach for delivering care in North Carolina. NCCARE360 helps providers electronically connect those with identified needs to community resources and allow for feedback and…

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  • As the basis for a BHAG to improve our nation's 'population health' and its 'healthcare', I offer a recent analysis of our nation's Social capital, county by county! Kyne & Aldrich. 2019. Capturing Bonding, Bridging, and Linking Social Capital through Publicly Available Data. https://doi:10.1002/rhc3.12183

    Among many definitions of SOCIAL CAPITAL, I offer one that might offer a better strategy for improving 'population health'.

    . SOCIAL CAPITAL may be defined as:
    . the bystander spontaneity to use the norms of trust, cooperation, and reciprocity
    . for resolving the social dilemmas occurring within a community
    . that becomes more uniformly expressed by the community's resident persons
    . when multi-generational caring relationships
    . increasingly permeate the community's social networks.

    CARING RELATIONSHIPS are defined as

    . a social interaction involving two persons
    . that begins with beneficence and deference for each other's autonomy,
    . thrives by each person's steady renewal of their adaptive skills, and
    . flourishes when the two persons communicate 'in harmony'
    . with warmth, non-critical acceptance, congruence, and empathy.
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