Social Determinants of Health and How They Affect a Small Rural Community (Case Study) Eastern Shore of Maryland

The Eastern Shore of Maryland is rural and is characterized by prevalent poverty, housing instability, lack of access to healthcare, chronic diseases, substance abuse, and issues with transportation to access healthcare services. The same problems exist for the population in Maryland and the United States. Understanding the challenges experienced by rural communities in Maryland is critical to addressing the vulnerable population. This study is an explanatory case study that examines the social determinants of health and how those affect small rural communities on the Eastern Shore of Maryland by examining literature published between 2016 and 2024. The literature reviewed resulted in three themes: the social determinants of health in rural communities, partnerships to address the social determinants of health in rural communities, and advocacy and the social determinants of health. Key issues identified in the literature include the critical nature of addressing the social determinants of health in the Eastern Shore's rural communities and how that must be undertaken by developing partnerships with a broad range of actors within the community and with stakeholders outside of the community, such as policymakers and funding organizations. Hospitals play a unique role in building community-based interventions and partnerships, and they have been shown in previous studies to be vital to initiatives addressing the social determinants of health and increasing better health and well-being outcomes for community members in rural areas. Advocacy, a focus on transportation, and education are essential to address the social determinants of health.