Determinants of Health for Community Paramedics

Determinants of Health: What Every Community Paramedic Needs to Know

Key Takeaways:

• Determinants of health are the broad range of personal, social, economic, and environmental factors that influence individual and population health outcomes.
• For community paramedics, understanding these determinants is essential to delivering effective, equitable, and preventative care.
• The most impactful determinants include social determinants of health (SDOH), health behaviors, physical environment, access to care, and genetics.
• Addressing these factors improves patient outcomes, reduces health disparities, and supports value-based healthcare models.
• Community paramedics are uniquely positioned to identify and intervene on these determinants during home visits and community-based interactions.

Introduction

As community paramedicine continues to evolve from a 911-centric model to one grounded in public health and preventative care, providers must develop a deep understanding of the determinants of health. These factors go far beyond the clinical symptoms seen on a call. They shape how patients live, what risks they face, and how successfully they can manage their own health.

In this article, we’ll explore the major categories of health determinants, how they intersect in real-world patient care, and why they’re a critical component of community paramedic education and practice. We’ll also preview how this understanding will tie into future topics like health assessments, care planning, and social service navigation.

The Five Core Determinants of Health

1. Social Determinants of Health (SDOH)

According to the World Health Organization and the CDC, SDOH are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect health outcomes (CDC, 2024; WHO, 2023).

These include:

• Economic stability (income, employment)
• Education access and literacy
• Healthcare access and quality
• Neighborhood and built environment (housing, transportation)
• Social and community context (support systems, discrimination)

For a community paramedic, this may mean recognizing when a patient keeps calling 911 due to lack of transportation to a clinic, or helping an elderly patient find food assistance to manage their diabetes.

2. Health Behaviors

Behavioral factors include choices that impact health—like diet, exercise, tobacco use, medication adherence, and alcohol consumption.

While traditional EMS may note these in passing, community paramedics have the time and context to engage patients in behavioral change. Teaching smoking cessation, safe medication use, or helping a patient with meal planning are all within this domain.

3. Physical Environment

This includes everything from air and water quality to home safety, noise, and climate. During home visits, paramedics might observe issues like mold, lack of electricity, or fire hazards. These aren’t just inconveniences—they can directly affect respiratory conditions, fall risk, and overall health.

4. Access to Health Services

Access doesn’t just mean proximity to care—it also includes affordability, insurance coverage, appointment availability, cultural competence, and health literacy.

Community EMS teams often encounter patients who lack a primary care provider, can’t afford prescriptions, or don’t understand discharge instructions. These access barriers are just as critical to resolve as the patient’s symptoms.

5. Genetics and Biology

While not modifiable, genetic predispositions and family history remain important. Community paramedics should note inherited risks for conditions like heart disease, stroke, or cancer and ensure appropriate screening and preventative measures are discussed or referred.

Why This Matters in Community Paramedicine

Understanding health determinants transforms the role of the paramedic from one of crisis responder to community-based health advocate. It helps:

• Prevent unnecessary EMS use by addressing root causes.
• Improve patient trust and compliance by demonstrating care for their lived experience.
• Support care coordination with other providers and social services.
• Collect relevant data to inform system-wide change and justify funding.

With this foundation, community paramedics can recognize when a blood pressure spike isn’t just a medication issue—but a sign the patient hasn’t eaten in two days due to food insecurity.

Conclusion

As healthcare shifts toward prevention, personalization, and equity, community paramedics are at the front lines. Understanding the determinants of health equips them to see the bigger picture, navigate beyond symptoms, and deliver truly impactful care.

In the next article, we’ll explore how to conduct a community health assessment, using these determinants to guide data collection, identify needs, and prioritize interventions.

References

Centers for Disease Control and Prevention. (2024). Social Determinants of Health. https://www.cdc.gov/about/sdoh/index.html
Orille, E., Steck, M. B., & Brannan, G. D. (2024). Determinants of Health. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK608013/
World Health Organization. (2023). Social Determinants of Health. https://www.who.int/health-topics/social-determinants-of-health

Ready to Learn More?

Stay tuned for the next article in our Community Paramedicine Training Series: “Social Determinants of Health: A Core Priority for Community Paramedicine” 🚑