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Amy J. Schulz, PhD, Shannon Zenk, PhD, Angela Odoms-Young, PhD, Teretha Hollis-Neely, BA, Robin Nwankwo, MPH, Murlisa Lockett, MA, William Ridella, MPH and Srimathi Kannan, PhD

Amy J. Schulz and Srimathi Kannan are with the University of Michigan School of Public Health. Shannon Zenk is with the University of Illinois at Chicago. Angela Odoms-Young is with Northern Illinois University. Teretha Hollis-Neely, Murlisa Lockett, and William Ridella are with the Detroit Department of Health and Wellness Promotion. Robin Nwankwo is with the University of Michigan Medical Center.

Correspondence: Requests for reprints should be sent to Amy Schulz, PhD, Health Behavior and Health Education, University of Michigan School of Public Health, 1420 Washington Heights, Ann Arbor, MI 48109 (e-mail: ajschulz{at}umich.edu).

Objectives. We examined a community-based participatory diabetes intervention to identify facilitators of and barriers to sustained community efforts to address social factors that contribute to health.

Methods. We conducted a case study description and analysis of the Healthy Eating and Exercising to Reduce Diabetes project in the theoretical context of a conceptual model of social determinants of health.

Results. We identified several barriers to and facilitators of analysis of social determinants of a community-identified disease priority (in this case, diabetes). Barriers included prevailing conceptual models, which emphasize health behavioral and biomedical paradigms that exclude social determinants of health. Facilitating factors included (1) opportunities to link individual health concerns to social contexts and (2) availability of support from diverse partners with a range of complementary resources.

Conclusions. Partnerships that offer community members tangible resources with which to manage existing health concerns and that integrate an analysis of social determinants of health can facilitate sustained engagement of community members and health professionals in multilevel efforts to address health disparities.

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