Applying a Social Determinants of Health Approach to the Opioid Epidemic.

Ohio is one of the hardest-hit states in the United States when it comes to opioid overdose deaths. Confronted with over 4,000 opioid overdose deaths in 2017, the Ohio Department of Mental Health and Addiction Services launched the Community Collective Impact Model for Change (CCIM4C) initiative to encourage 12 Ohio counties to think more deeply about primary prevention. By moving upstream and taking a look at the causes of the opioid crisis, the counties involved in the CCIM4C initiative were able to expand the range of potential partners and potential solutions, moving from emergency response alone to broader efforts to support social connection, economic security, and other social determinants of health. Each county brought together a wide array of partners, including local employers, community colleges, health care organizations, faith leaders, youth-serving organizations, first responders, librarians, school board members, public health officials, parks and recreation staff, and people with lived experience. This article focuses on the efforts of three counties-Ashtabula, Lorain, and Lawrence-to take on the community conditions that increase the risk of unhealthy substance use and addiction. It describes what they learned as they went beyond a sole focus on preventing opioid overdoses and deaths-as critically important as that is-to transforming their communities to support health and well-being in the first place.