Social Determinants of Health
Communities that are disempowered, have lower socio-economic status and have higher exposure to risk factors—including chronic stress and systemic racism—have worse health and shorter lives. Understanding and actively addressing underlying community-level factors can improve health equity, reduce child death rates and raise the quality of life.The Five Domains that Comprise the Social Determinants of Health
Black Child Legacy Campaign (BCLC) partners work within their neighborhoods to improve all indicators within the five domains that comprise the social determinants of health:
Education Access and Quality
- Educational Attainment
- Chronic Absenteeism
Economic Stability
- Children Living in Poverty
- Youth Homelessness
Health Care Access and Quality
- Prenatal Care
- Preterm Births
- Low Birth Weight
Social and Community Context
- Child Maltreatment
- Foster Care
- Juvenile Felony Arrests
- Impacts of COVID-19
Neighborhood and Built Environment
- Neighborhood Safety
- Food Safety
BCLC understands, addresses and evaluates the social determinants of health for Black residents in its seven focus neighborhoods in Sacramento.
Learn more about the health of our communities on our Neighborhood pages.
Education Access and Quality
Improving educational outcomes is essential for advancing equity and long-term well-being in communities. High school graduation is a foundational milestone that opens pathways to higher education and employment, helping to reduce poverty and reliance on public assistance. Beyond graduation, attaining higher education—whether through a bachelor’s degree or vocational training—can significantly enhance lifetime earnings, career mobility and intergenerational opportunity. However, students of color face systemic barriers such as structural racism and unequal access to resources, affecting their graduation outcomes and leading to chronic absenteeism. Black residents in BCLC’s neighborhoods attain bachelor’s degrees at significantly lower rates than other groups. Addressing these areas is critical to ensure that all students, particularly Black youth, have the support and opportunities needed to thrive academically and economically.
Our Progress
- Higher education among Black residents of Oak Park increased by more than 200% since 2014.
- Black students in BCLC neighborhoods had slightly higher four-year graduation rates than all other groups, with increases in nearly all districts.
- The proportion of Black residents with a bachelor’s degree or higher in Sacramento County rose by 6% since 2014.
Economic Stability
Addressing childhood poverty and youth homelessness is essential to promoting equity, stability and long-term opportunity for Black youth. Children living in poverty face compounded challenges that affect their health, education and overall well-being, including limited access to nutritious food, quality schooling and medical care, as well as increased exposure to environmental hazards and chronic stress. These conditions can hinder academic achievement and perpetuate cycles of disadvantage. Youth homelessness, often rooted in systemic inequities and adverse childhood experiences, further disrupts education and development, leading to unmet basic needs, mental health challenges and reduced access to support systems. These challenges remain especially urgent in BCLC’s neighborhoods, where more than one-third of Black/African American children live below the poverty line—significantly higher than other groups. For BCLC, these issues matter because they reflect broader structural disparities and demand coordinated policy and community responses. Investing in inclusive education systems, housing stability and culturally relevant support services can help break these cycles and create pathways to success for vulnerable youth.
Our Progress
- 39% decrease in poverty among Black children in Sacramento County between 2014 and 2023.
- Overall decline in poverty rates among Black residents across BCLC’s neighborhoods, despite remaining higher than other racial groups.
- Increased identification of homeless youth in schools, suggesting improved outreach and support systems.
Health Care Access and Quality
Ensuring equitable access to quality maternal and infant health care is vital for improving outcomes and reducing disparities faced by Black families. Early and consistent prenatal care plays a crucial role in preventing complications during pregnancy and childbirth, supporting healthier outcomes for both mothers and babies. However, systemic barriers such as racial discrimination, geographic access and affordability continue to limit timely care for many—nearly one in four Black women in BCLC’s focus neighborhoods did not receive prenatal care in their first trimester. Preterm births, which are more common among Black women, pose serious risks to infant survival and long-term development, and are often linked to chronic stress and inadequate health support. Similarly, low birth weight increases the likelihood of infant health problems and is frequently associated with preterm delivery and environmental factors that disproportionately affect communities of color. For BCLC, addressing these interconnected issues means investing in culturally responsive care, community-based support systems and policies that dismantle structural inequities in health care access and quality.
Our Progress
- Preterm births in Del Paso Heights and North Sacramento dropped from 19% in 2021 to 9% in 2023.
- Identification of neighborhood-level variation allowed targeted interventions where prenatal care delays and low birth weight rates are highest.
Social and Community Context
Creating safe, supportive environments for children and youth is essential to their long-term health, development and opportunity. Experiences such as child abuse, foster care placement and juvenile justice involvement are often rooted in systemic inequities and can have lasting impacts on mental health, education and stability. For Black children in Sacramento County, these risks are compounded by structural racism, poverty and under-resourced communities. While progress has been made in reducing foster care entries and substantiated abuse cases, significant disparities persist—Black youth accounted for 54% of all juvenile felony arrests in 2023, despite representing a much smaller share of the population. Addressing these challenges requires a shift from punitive systems to prevention-focused, community-based supports that prioritize family stability, racial equity and trauma-informed care.
Our Progress
- A 57% decrease in substantiated child abuse allegations among Black children in Sacramento since 2015.
- A 60% decrease in foster care entry rates for Black children in Sacramento County between 2015 and 2024.
- A countywide decline in foster care entries, reflecting a broader shift toward family-centered and community-based support strategies.
Neighborhood and Built Environment
The neighborhoods where people live have a profound impact on their health, stability and overall quality of life. For Black communities in Sacramento County, housing affordability and neighborhood safety remain critical concerns. High housing cost burdens can limit access to other essentials like food, healthcare and transportation, while also increasing stress and the risk of housing instability. In BCLC’s neighborhoods, Black households spend a disproportionately high share of their income on housing—up to 36.6% in neighborhoods like Arden-Arcade—highlighting the financial strain many families face. At the same time, perceptions of neighborhood safety influence residents’ ability to engage in healthy behaviors and access community resources. Addressing these challenges requires systemic investment in affordable housing, equitable zoning and community-driven safety initiatives that reflect the lived experiences and priorities of Black residents.
Our Progress
- A slight increase in perceived neighborhood safety among Black residents in Sacramento County since 2014
- Availability of neighborhood-level housing data in the BCLC focus area enables more targeted interventions and policy responses