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 are creating a National Action Agenda to Advance Upstream Social Determinants and Health Equity. The initiative’s intent is to instigate and implement tangible, systems-level change across Health, Human Services, Education, Public Health, Public Safety and other domains. The need for doing so is vividly illustrated by the racial and socioeconomic disparities being laid bare in our country today.

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

  • 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 are helping to shape the National Action Agenda, each focusing on a different Social Determinant: Community & Social ContextEconomic MobilityEducationHealth Care & Behavioral Health SystemLegal, and Neighborhood & Physical Environment. Each team has its individual workplace on the NAA Group page, which you can get to by clicking the team name in the navigation bar. Each workspace is where that team’s members can share and view resources, post questions, work collaboratively, and catch up on the latest news and meeting information as it pertains to their topic area.

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 (and particularly on “upstream” activities in communities nationwide) is long overdue – and should be a critical component of our country’s post-coronavirus rebuilding activities;
  • The agenda should be shaped and launched before, not after, we get to the other side of the nation’s simultaneous public health, economic and social upheavals;
  • The need to work more explicitly for equity – in health and more broadly – is stark and clear. Interoperability is a critical way to pursue that goal by routinely providing the information needed both to clearly see the impact of racial/socioeconomic disparities and to address them.
  • This is potentially 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)


  Recent/Featured Resources

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 Recent/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


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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 connection for improving HEALTH.

    . SOCIAL CAPITAL may be defined as:
    . the spontaneity occurring among a community's resident persons
    . for using the norms of trust, cooperation, and reciprocity
    . to resolve the social dilemmas they encounter daily
    . that becomes more readily expressed by the community's 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 beneficent respect for each other's autonomy,
    . thrives by each person's steady renewal of their adaptive skills, and
    . flourishes from a timely intent to communicate 'in harmony'
    . with warmth, non-critical acceptance, congruence, and empathy.
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