Identify one social determinant of health (SDOH) affecting the subpopulation described in part A. 1. Explain how this SDOH is affecting the subpopulation described in part A. Your explanation should address the following questions and be supported with local, state, or national data: • What is the biggest contributor to disease (morbidity) and premature death (mortality) in the community?

Social Determinants of Health (SDOH)
According to a recent community health needs assessment report published by Brookwood
Baptist Health, access to care is one social determinant of health (SDOH) for low-income
individuals. Most uninsured people state that the main reason they do not have insurance is cost.
Many do not have access to coverage through a job, and some people, particularly poor adults in
states that did not expand Medicaid, remain ineligible for financial assistance for coverage
(Brookwood Baptist Health, 2020). Those without insurance tend to have worse access to care
than those who are insured. One in five uninsured adults in 2018 went without needed medical
care due to costs (Brookwood Baptist Health, 2020). Furthermore, studies have shown that those
without insurance are less likely to receive preventative care and services for major health
conditions and chronic diseases than those who are insured.
B1. Explanation of SDOH Impact on Subpopulation
The leading cause of death in the state of Alabama is heart disease (Centers for Disease
Control and Prevention [CDC], 2022). In 2017 Alabama was ranked fourth in the nation due to
13,110 heart disease deaths in that year. Environmental and behavioral factors that contribute to
heart disease are high blood pressure, high cholesterol, diabetes, being overweight or obese,
eating a diet high in saturated and trans-fat, smoking, and living a sedentary lifestyle.
Food deserts are controversial community health concern. Many believe that the term
“desert” incorrectly implies that a lack of affordable and healthy food is naturally occurring, and
a better term to describe the subject is food apartheid, which also includes the discrimination of
communities of color regarding economic opportunity and access (Bailey, 2022). Close to two
million residents in Alabama live in a food desert. Almost 150,000 of them live in Birmingham
and accounts for 69% of the total population of the city. In 2019 it was discovered that there is at
least one area in each of the nine Birmingham City Council Districts that are food deserts.
Most residents I have encountered through my field experience struggle to find
transportation. They are unable to make to and from doctor visits, go to the grocery store, or visit
family. While there is public transportation, many must walk a distance to the bus stops and there
is no covered waiting area. Most residents in poor health are unable to walk any distance to these
stops, nor are they able to wait in the elements for the buses. Most request to be place in the
hospital for continuous care because they are unable to care for themselves at home or make it
back to weekly appointments. This results in most patients seeking care in the emergency
department and being admitted to the hospital for care