IHELP is an acronym used in community health and health justice approaches and disciplines of healthcare to categorize the social determinants of health. The social determinants of health, also referred to as the social drivers of health, can be defined as non-medical environmental, and social factors that impact an individual or greater communities’ healthcare outcomes. These include education, income, immigration status, legal status, employment status, and more.
Understanding the social determinants of health can lead to better identifying and addressing the non-medical issues facing communities. Additionally, community health advocates can better target solutions that address the short and long-term impacts the determinant has – which can help improve the quality and outcomes of visits – leading to more equitable health outcomes.
IHELP is an acronym that stands for income, housing, education and employment, legal status, and protections. The acronym is used as a categorization tool for identifying and grouping social determinants. Each represents a different environmental or societal determinant that can impact individual or community health outcomes. The IHELP acronym stands for:
I: Income
The Impact: Income has both a direct and indirect effect on health outcomes. Those who struggle to maintain a steady income, earn a lower wage, or have experienced a series of financial barriers or burdens face a multitude of challenges specific to healthcare – including less access to health services, long lapses or complete loss of health insurance, inability to afford medical care services, and in some cases foregoing medical care or services due to financial insecurity.
Community Health Approach: Initiatives in community health primarily focus on helping those experiencing financial difficulties through direct services and support. Establishing more community health clinics, connecting patients with financial assistance services, and reducing barriers to care within low-income communities help improve health outcomes.
Health Justice Approach: Through legal intervention, health justice aims to work with those who may have external implications for income status – including working with those who may have lost or been denied health coverage through work, those who may not be receiving fair wages, those who were unjustly or falsely denied or lost employment, or those who may have been falsely denied health services due to income-related determinants.
H: Housing
The Impact: Those who experience housing difficulties, including those who are unhoused, face many challenges and barriers when it comes to achieving successful healthcare outcomes. Difficulties such as being unhoused, living in sub-standard housing, living in unsafe or unhealthy environments, or living in health, food, or service deserts can significantly impact the frequency and outcomes of healthcare.
Community Health Approach: Community health initiatives and efforts have been made to identify and provide services to those who are unhoused or facing housing insecurity. Such efforts include pop-up clinics, establishing free health and wellness clinics in neighborhoods, and providing mobile support services to those in need. Education and awareness around health and wellness is also a critical component to ensuring the unhoused are cared for.
Health Justice Approach: Legal interventions often involve working with those who require legal assistance for housing-related matters. Examples include those who may be facing unlawful or illegal evictions, living in unhealthy or dangerous housing, issues or disputes with landlords, or helping those who are unhoused find housing services.
E: Education & Employment
The Impact: The link between education and employment can have a significant impact on health outcomes. Often intertwined with one another, the impacts of those facing barriers in education as children and adolescents can lead to earning lower wages, obtaining less wealth, and having access to less quality healthcare plans. This can also translate to employment barriers such as less steady or reliable employment, maintaining less quality health insurance or having no health insurance at all, working dangerous jobs, and foregoing healthcare to maintain employment.
Community Health Approach: Community health often plays an important role in ensuring that individuals and communities are not only provided with medical services but are educated and guided in their healthcare journey. Initiatives and programs designed to educate about mental and physical health, nutrition, pre-existing conditions, and healthy lifestyle choices are some ways community health professionals work to advance healthy lifestyles and promote services.
Health Justice Approach: Health justice aims to work with those who may have experienced educational or employment discrimination. This includes aiding patients who need medical accommodations for mental or physical disabilities, working with those who may have unjustly lost employment or health benefits through employment, or legal accommodations.
L: Legal Status
The Impact: Legal status such as immigration or veteran status can impact healthcare outcomes. In many cases, those navigating, applying for, or awaiting immigration decisions are aware of the benefits available to them. Veterans are also a legal status group who have a multitude of resources and benefits available to them, but many are unaware of what exactly they are.
Community Health Approach: Community health approaches to legal status impacts include information campaigns, awareness initiatives, and assistance programs for veterans and those navigating the immigration system. Additionally, working to establish service centers and care centers for those with legal statuses is also critical for those facing legal barriers.
Health Justice Approach: Through a medical-legal partnership, veterans and immigrants can receive information on available benefits and connect with health services. Legal assistance can also be applied for those who may have been wrongfully or unjustly denied health benefits.
P: Protections
The Impact: Making difficult – sometimes life-changing – healthcare decisions is not easy – especially concerning children and the elderly. In many cases, individuals and families are unaware of how to navigate these barriers and may not be familiar with their rights.
Community Health Approach: Similar to legal statuses, awareness around benefits, protections, services, and supports can go a long way for individuals and families who may be considering or currently navigating guardianship, conservatorships, or medical power-of-attorney circumstances. Working with individuals who are navigating these statuses, along with connecting them to greater resources and support if needed promotes better education, knowledge, and outcomes.
Health Justice Approach: Health justice aims to ensure the enforcement of protections by offering guidance and support by working with families to protect rights, assets, and well-being. This can include providing legal advice, intervention, and support to those who are unfamiliar with rights or who may be facing discrimination, abuse, or mismanagement of protections.
A Community Health Investment Certificate prepares students to cultivate and implement collaborative opportunities between public and private healthcare providers, community partners, and their constituents. The certificate program prepares students to promote and expand health equity within communities by identifying and addressing the social determinants of health.
The Health Justice Certificate is designed for bachelor’s degree recipients looking to expand their health toolbox to include medical-legal partnerships in addressing the social determinants of health and its impact on patient care. Health justice holds a more personalized approach, with graduates working directly with hospital leadership, community advocates, and patients to address social determinants and improve healthcare outcomes. Candidates for health justice roles are not limited to healthcare, however, and can come from across the business and social services.
Pursuing a post-bachelor’s certificate can open new and exciting opportunities for bachelor’s degree holders. Whether for a job promotion, a new area of study, or credits, a post-bachelor’s certificate is a great way for working professionals and continuing ed students to learn new skills and prepare for new and rewarding academic and vocational opportunities in their lives.
