Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks.” (Healthy People 2030). Examples of social determinants of health include things such as access to quality education, safe affordable housing, access to nutritious foods at affordable prices, racial discrimination and violence, poverty, quality of clean air and water, transportation, access and affordability to quality health care, and sidewalks and parks in neighborhoods. 

According to the Kentucky Department of Health’s 2020 Kentucky Diabetes Fact Sheet, 14.6% of adults in northern Kentucky have been diagnosed with diabetes, and another 9.7% have been diagnosed with prediabetes.  To address some of the SDOH experienced by adults in northern Kentucky and to educate them about making heathier choices, the Kenton County Cooperative Extension Service’s Nutrition Education Program (NEP) Senior Assistant continued a partnership she had established with other non-profit agencies in the area. Faith Pharmacy, a non-profit agency that provides necessary prescription drugs to people who cannot afford them, Be Concerned, one of the largest food pantries in northern Kentucky, St. Elizabeth Hospital, and Humana health insurance agency partnered with the NEP Senior Assistant to offer a Healthy Choices for Every Body 7-session series to adults previously diagnosed with diabetes or prediabetes. Topics included making healthier food choices, planning meals, making a grocery list, purchasing food wisely, storing and preparing food safely, and budgeting their money to make it go farther. As a part of each session, the Senior Assistant prepared a healthy recipe to reinforce the cooking skill addressed with each lesson. The participants were able to sample the recipe in class, and they received the recipe and a free kitchen tool to help them duplicate the recipe at home.  A registered dietician from St. Elizabeth Hospital was present at each session to present relevant dietary guidelines for the participants and to answer any questions they had about their diagnosis.

To encourage attendance, several participants were provided with a ride to get to the class. All participants were also given a $25 gift card at each class to be used towards the cost of gas to get to the class or to increase their food budgets. To help them make the recipe from class at home and to supplement their food needs for the week, all participants received a bag of groceries at each session. In addition, the participants of the series were able to receive supplemental groceries from Be Concerned for three months after the series ended.  The series not only provided vital education for the participants, but it also met physical and emotional needs by providing food for them to take home and a safe place to establish friendships with people who had common needs and health concerns. 

The series greatly impacted the 12 participants who completed it. According to a web-based National Reporting System (WebNEERS), at the end of series, 100% showed improvement in one or more diet quality indicators (eating more fruits and/or vegetables, drinking less soda, and cooking dinner at home).  Fifty percent were planning their meals more frequently, using a written food spending plan, checking for food items on sale at the store, and budgeting enough money for their food purchases.  Fifty-eight percent of the participants were thawing food at room temperature less often and using a meat thermometer more frequently.   According to data from a University of Kentucky Food and Nutrition Specialist, every person who receives education regarding some aspect of food borne illness prevention, saves their state an estimated $1,000.  Potential savings to Kentucky citizens, businesses, and government due to food safety education included in this Healthy Choices for Every Body series is $7,000.

The series addressed several of the SDOH for participants, and the successful collaboration between the agencies will continue to offer the series for new participants within the next year.