Recentering Place As a Social Determinant of Health: Intersections Among Home, Health, and Equity

Where we live, grow, and interact directly impacts our health (de Leeuw, 2018; Sousa, Kemp, el-Zuhairi, 2019). Indeed, places are sites of both wellness and inequity, with power happening not within places, but through places (Kemp, 2010). Accordingly, in this roundtable, we build a case for understanding place as a core social determinant of health (SDOH), arguing for a deeper understanding of the health equity implications of threats to place and place sovereignty through forced migration, political/state violence, and environmental racism.

Together, we demonstrate the importance of understanding how assaults on and violations to place (particularly homeplaces) disproportionately impact the health of marginalized populations, particularly BIPOC, immigrant, and/or those in intergenerational poverty. Rooting our discussion in place, we draw on Akessons (2022) work on cumulative domicide (describing attacks on the human right to home as ongoing, deliberate parts of larger processes of dispossession and oppression), connecting it with the shared concepts of structural (Galtung, 1969) and slow (Nixon, 2011) violence, which helps us conceptualize violence as chronic, insidious, and often obscured.

Our first set of presenters establish the initial framing for understanding place and home as core determinants of health equity, describing the imbrication of environmental assaults and forced displacement with settler-colonialism, racism, and disaster capitalism. Using Indigenous, anti-colonial, and Critical Race theories, they explore health consequences of spatial deployments of power/disempowerment, citing shared and individual work among women in Palestine; Syrian refugee families; and working-class, Indigenous, and BIPOC youth and families experiencing displacement due to climate disasters in the United States.

Our next set of presenters lay out the human rights and health equity implications of loss of place for two persecuted populations facing political violence and forced displacement: (1) the Rohingya ethnic minority group, who has lost their homes and been forced to flee their communities in Myanmar due to a violent ethnic cleansing campaign, while also risking the loss of their temporary homes in Bangladeshi refugee camps due to climate-induced disasters, and (2) unaccompanied children who have migrated to the US, fleeing centuries of corruption, civil war, oppressive regimes supported by the US, and increasingly frequent climate disasters that have contributed to tenuous economic and political situations throughout Central America.

Carrying through the theme of loss of place, our final presenter mobilizes Indigenous theory, drawing on the notion of Ko au te whenua, te whenua ko au (I am the land, and the land is me) and findings from Kaupapa Maori research with child welfare-involved young people in New Zealand to illuminate the critical role of dispossession from tribal homeplaces in disruptions to identity, belonging, and wellbeing that come with child welfare involvement.

Using these rich examples, presenters will highlight the implications of place for health equity, attending to the ways place determines physical and mental wellbeing, particularly with regards to home and belonging. We end by discussing the contributions of liberatory, de-colonial social work scholarship for practices and interventions that promote health equity by defending people's rights to, sovereignty over, and continuity with and within place.