About
This page identifies six interventions from the HI-5 initiative that address social determinants of health, describes how they benefit society, and provides evidence of their impact.
Clean Diesel Bus Fleets
Under these transition programs, fleets of diesel buses are retrofitted to operate using clean diesel technology. The body of scientific evidence demonstrates these reductions are associated with fewer cardiovascular events and respiratory conditions, including asthma, and improved lung function among children.
Earned Income Tax Credits
Earned income tax (EITC) credits are usually implemented as refundable income tax credits levied at the federal, state, and/or local levels that benefit low- and moderate-income working individuals and families. The EITC has been credited with keeping more families and children above the poverty line than any other federal, state, or local program. In addition, the evidence demonstrates that EITC is associated with reductions in infant mortality and preterm births, and improvements in birthweight and maternal mental health.
Early Childhood Education
Early Childhood Education (ECE) programs foster socio-emotional, cognitive, and motor skill development for children ages 3 to 4 years. Some programs also include
- physical activity
- nutritious meals
- parental support
- health care screening and access
- social services
ECE programs may be delivered in a variety of ways and settings:
- state and district programs (available to all children)
- the federal Head Start program
- model programs (which focus on at-risk and/or economically disadvantaged children).
In addition to improved cognitive development, the evidence shows that ECE programs are associated with reductions in
- obesity and BMI
- child abuse and neglect
- youth violence
- emergency department visits
Home Improvement Loans and Grants
These financial resources provide funding to low-income families to repair and improve their homes. For example, funds may cover weatherization to improve insulation, air quality, dampness, and energy conservation, as well as removal of health or safety hazards from homes. The evidence demonstrates that these interventions are associated with improving residents’ general health and in reducing asthma symptoms and non-asthma related respiratory problems.
Public Transportation System Introduction or Expansion
The purpose of introducing or expanding public transportation systems is to increase both access and use of public transit and to reduce traffic. The body of evidence demonstrates this intervention is associated with reductions in traffic crash injuries, fatalities, traffic congestion and associated air pollution as well as increasing levels of physical activity.
Water Fluoridation
Water Fluoridation: Community water fluoridation is the process of adjusting fluoride in water in order to improve oral health. Drinking fluoridated water keeps teeth strong and reduces tooth decay by approximately 25 percent in children and adults. By preventing tooth decay, community water fluoridation has been shown to save money, both for families and the health care system.