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What are Social Determinants of Health and why should you care?

What are Social Determinants of Health and why should you care?

By Cindy Stickel RN, BA, CCM / Faith Community Nurse, Penrose-St. Francis-Mission Outreach

The Colorado Trust ( defines Social Determinants of Health (SDOH) as “factors that can either positively or negatively impact the ability for all Coloradans to lead healthy, productive lives…important aspects that influence overall health.”

The World Health Organization ( describes SDOH as “circumstances into which people are born, live, work, and age; and the systems put in place to deal with illness…”

Simply stated, SDOH are those social factors that affect health and the ability to be healthy.

You are affected by SDOH, either in a positive or negative way. For example, studies show that health tends to follow class systems: the higher the social position, the better the health.

60% of your health is determined by your behavior, environment, and social status. That is followed by 20% genetics and 20% healthcare access.

What are some of the Social Determinants of Health that impact your overall wellbeing?

  • Your biology and genes: health challenges or advantages
  • Personal health practices and coping skills: your ability to make choices that prevent disease
  • Your income and social status: strong relationship between your health and your social standing
  • Your education and literacy: highest level of education and ability to read affects your health
  • Your gender: demands that society puts on different genders and sexual orientation
  • Your access to healthcare
  • Food stability and your access to nutritious foods
  • Employment/working conditions: job security, safety, job benefits
  • Social environments: social support from your family/friends, church or faith community
  • Spiritual support: Whole wellness includes your mind, body, and spirit. Many health issues stem from a lack of spiritual support like loneliness, isolation, hopelessness, fear.
  • Your physical environment: stable and safe housing, transportation, air and water quality, neighborhoods; studies have shown an enormous impact on health: The average life expectancy in the homeless population is 42-52 years compared to 78 in the general population…a 30-year discrepancy!
  • Healthy child development: your early experiences affect brain development and school readiness – which carries into adulthood.
  • Your culture: language barriers, access to culturally appropriate healthcare and services

Last year, the Penrose-St. Francis Faith Community Nurses conducted a study, looking at what social factors affect clients’ health. After meeting with visitors at the Neighborhood Nurse Center at Tri-Lakes Cares, the results were troubling:

  • 52% had no income or were living on a fixed income, such as social security or disability
  • 71% had food insecurity (reported times of not having enough food to eat)
  • 45% lacked consistent transportation resources
  • 40% lacked access to a primary health care provider

As you can see, our clients noted being significantly impacted by several SDOH, including jobs/income, access to food, transportation, and healthcare.

This is surprising data, but what can we do in response?

Well, first and foremost, Faith Community Nurses cannot solve these issues alone. We collaborate with local community service organizations, like Tri-Lakes Cares, and work as a team. This partnership brings together diverse services under one roof for the underserved people living in northern El Paso County, who often don’t have access to services in Colorado Springs. It takes community partnerships to address the effects that social factors play on our neighbors’ health.

Understanding and addressing SDOH is essential to provide equitable, effective, and high quality holistic care to those we serve.

At Tri-Lakes Cares, we’ve created and improved programs to reduce poverty and factors leading to crisis. We provide a hand up during a crisis, and increase access to resources like food, clothing, housing, and transportation.

Penrose-St. Francis Faith Community Nurses at Tri-Lakes Cares serve as part of this team. We strive to improve medical services, coordinate access to healthcare, including medical, dental, mental health, and provide emotional and spiritual support – focusing on community wellness.

Together, we provide a holistic model of health, addressing the various levels of need: physical, emotional, mental and spiritual!

As a team we refer clients to appropriate resources depending on particular needs, using staff and volunteer strengths and expertise. For example, a client may come in for food from the pantry, but a thorough assessment by the case managers and/or the nurse results in them leaving with much more, like prescription assistance, access to medical care, utility or rent assistance.

Every client we see, we ask the question, ‘How can we help?’ And ‘How can we as a community team address the needs today and plan for the future?’ in order to positively affect the wellbeing of our clients, and thus, improve their ability to be healthier and stronger.

That is the ultimate goal as we think about Social Determinants of Health.



Cindy Stickel is a Penrose-St. Francis Faith Community Nurse who staffs the Neighborhood Nurse Center at Tri-Lakes Cares in Monument. She is part of a team of six Faith Community Nurses who are assigned to community service agencies throughout El Paso County, bringing the Centura Mission to life in the community by encouraging health and healing, advocating for the most vulnerable, building relationships with neighbors in the community, reaching out and listening to those who are hurting, and creating hope.

Giving what is needed vs Giving what you want to give

Giving what is needed vs Giving what you want to give

This time of year, everyone wants to help those who are less fortunate.

When a natural disaster strikes (think the hurricanes in Texas and the Caribbean earlier this year) people want to help but donate the wrong things. For instance, does someone who lives in the tropics really need your old winter coat, even if they have lost everything to a hurricane? More likely, they need fresh water, cleaning supplies and building materials.

Similarly, think about what is needed on a local basis. Tri-Lakes Cares strives to meet the specific needs of those we serve in our community. Our Giving Tree program provides the opportunity for generous individuals to donate specific items requested by children and seniors. Our Holiday Food program gives all the fixin’s to our families to create a holiday meal at home – they can take the items and cook them at home, making memories beyond the hard times they currently face.

As impersonal as it may seem, sometimes the best thing you can do is make a financial donation. When I worked for an international aid organization back in the mid-1990’s, it was more cost effective for us to receive cash donations which were then used to purchase much needed humanitarian supplies in Europe to be shipped directly to the war-torn areas of Bosnia. If we had tried to purchase those items in the U.S. and arrange for shipping and transportation, we would have helped a lot fewer people with meager supplies.

In the same manner, Tri-Lakes Cares can leverage your donations to purchase food through Care & Share at a much reduced rate. Your $20 can purchase up to 100 lbs of food, supplementing the many donations we receive through food drives and collections in the community. In addition, your financial contribution can help with things such as rent assistance and utilities payments. This may not seem “sexy” but it can make a huge difference in the lives of those who are struggling to keep a roof over their head or make sure their families stay warm.

So, before you start collecting coats or toys or other items, contact us (or any of your preferred charities) and find out what is really needed. It may not be what you think it is.

Christine, Development Manager at TLC, worked for an international aid organization in the mid-1990’s and wrote this blog from personal experience having to provide humanitarian aid overseas.

‘Tis the season for food drives!

‘Tis the season for food drives!

Like many food banks and food pantries, Tri-Lakes Cares is entering the hectic season of food drives when community groups and individuals collect food for our pantry. With your support last year, our pantry distributed over 200,000 lbs of food through the various programs!

We are so grateful for the generosity of so many BUT sometimes the items donated are not always the most useful or the most needed to stock our shelves.

Here are a few guidelines to consider when hosting a food drive:

Visit our Current Pantry needs page to see what is most needed: Pantry Current Needs  You can also call Michèle, our Food Programs Manager to inquire about specific needs at (719) 481-4864, ext 111. She can also provide you with collection bins for smaller drives and answer any questions about donating food.

Large packages or cans are great money savers for the buyer BUT unless a family has 10 members or more in the household, these large sizes are impractical for our food pantry. We are not set up to break down large bags or boxes of beans, rice, flour or other staples (10 lbs or larger) and typically we send them to the Marian House Soup Kitchen on our Friday morning bread runs.

Avoid baby food. Believe it or not, there is little demand for these items. Most families that have infants or small children benefit from the WIC program (Women Infants and Children nutrition program) which provides them with infant formula and baby food. Most of our client families have older children and the occasional donations we receive of baby food are sufficient to meet the needs.

Exotic foods. Every food pantry receives those odd ite ms (usually left over from gift baskets) like canned oysters, wild game, oddly flavored coffees or condiments, strange vegetable combinations, etc. These items can be donated – paying attention to “best use” by dates (more on that in the next bullet) – but often they will remain sitting on our shelves as long as on your own pantry shelves.

What about those “best use by” dates or “sell by” dates? Believe it or not, these are not required by federal law (according to the USDA website), except for on infant formula. Dates are provided by manufactures to help consumers determine the best quality and time of consumption of food products. There is a lot of confusion revolving around these dates, but a good rule of thumb to follow is within one year of the date stamped on the can or box is acceptable. Anything older than that, we will not be able to use.

Watch out for those dents and broken boxes! Please do not donate cans that are severely dented, boxes that are torn or open, or any open or started food items. We will just have to dispose of them.

Consider nutrition value. A large number of the clients we serve are senior citizens, who are struggling to make ends meet. Items such as gluten free, low sodium and low sugar can be in demand, but if we don’t have it on our shelves, it makes it difficult to meet those needs.

If you don’t want to donate food, there are two other ways that you can help our pantry:

Shop “Buy It Forward”. Once a month on the first weekend of the month, the King Soopers on Baptist Road offers pre-packaged bags of the current month’s grocery items needed for our pantry. When you do your own grocery shopping, add a “Buy it Forward” bag to your cart. The bags are collected and picked up by a volunteer and delivered to Tri-Lakes Cares. It’s easy and doesn’t require any extra shopping on your part.

Donate! Believe it or not, your financial contribution can be stretched further through the buying power we have with Care & Share Food Bank, where we can typically pay 19 cents per pound for food. Your $25.00 could purchase 132 lbs of food and other items; or support other needs in the pantry. Click on the big “Donate Now” button at the top of the page to make a contribution today!

However you choose to support us, our most heartfelt thank you!

In the eyes of our clients – How are we doing?

In the eyes of our clients – How are we doing?

Periodically, we like to know how we are doing and what impact our programs and services have on our clients’ lives. In order to capture this information, we conduct periodic anonymous surveys, asking clients questions on how the help they received made a difference in their lives.

Check out this cool infographic created by Francisca Blanc, our Development Associate, to visually show some of the results from our most recent survey.

Too much Zucchini? Share the bounty!

August 8th is National Sneak Some Zucchini Into Your Neighbor’s Porch Day!

Ah Zucchini! Easy to grow and quick to take over the garden of an unsuspecting gardener (especially the novice), the ubiquitous zucchini is a summer squash that can be served up in so many ways – sautéed, roasted, boiled, fried, added to bread recipes, muffins and other baked goods. A search on Google quickly turns up nearly as many recipes as a single plant does zucchini.

Seriously, access to fresh fruits and vegetables is often difficult for those with limited means, including the individuals and families who come to Tri-Lakes Cares. Through our “Help Yourself Market” and the generous donations of our food rescue partners, we are able to offer a wide variety of produce – both familiar and sometimes odd – that many of us take for granted.

If you are a gardener, you can help by donating any extra tomatoes, lettuce, herbs, green beans, and yes, even zucchini! And, you don’t even have to sneak it onto our porch – ring our doorbell and we will gladly take it in.

Do you have a favorite zucchini recipe? Share it in the comments section and we will re-share with our clients, volunteers and staff.

Imagine if Apple had to run like a nonprofit

Many people comment on how a nonprofit should be run like a business, but what would happen if a business was expected to run like a nonprofit, with the expectations that the public has of a nonprofit? Vu Le, Executive Director of Ranier Valley Corps, and blogger for the nonprofit world (Nonprofit…and Fearless), has imagined this in a recent blog posting.

Imagine if Apple had to run like a nonprofit

We nonprofits deal with unique challenges that our for-profit colleagues never have to think about. If you ever sat in the dark for hours listening to REM and eating Otter Pops and wondering what it would like for a large for-profit like Apple to have to run like a nonprofit, wonder no more! I’ve done it for you this week! (What, like your vacation is so much more interesting). And I asked NAF’s web designer and artist, Stacy Nguyen, to draw up some comics.

At the retail store:

Customer: Hi, I’d like to buy this latest iPhone. How much is it?

Apple employee: $700 dollars.

Customer: Here you go. But I want most of this money to be spent on direct costs. No more than $70 should be going to indirect costs like rent, insurance, etc. I also don’t want any of this $700 to go toward advertisement or staff salaries.

Apple employee: We’ll designate these restrictions in our systems.

Customer: At the end of the year, I’d like a report on what you spent this money on.

Apple employee: We provide quarterly financial reports, and would be glad—

Customer: No no no. I don’t want the financial reports on your entire company. I only want a report on what my $700 specifically was spent on. Only my $700.

Apple employee: OK…Would you like to be added to our e-newsletter list?


Meeting with a key shareholder:

Tim Cook, CEO: As you can see, this quarter we surpassed our sales goal, moving over one million units, which is 15% more than we had anticipated.

Shareholder: Congratulations, that’s really wonderful to hear. But…that’s more like an output. What are your outcomes?

Tim Cook: I’m glad you asked! Of the one million iPhones we sold, over 223,000 people used their phones to update their resumes and applied for jobs. Of that population, almost 15% then actually got a job. Meanwhile, about 115,000 seniors buy our phones, and surveys indicate that nearly 7% use their phones to go on to WebMD after they fall and break their ankle. Our phones allow these seniors to figure out how to create makeshift tourniquets for their broken ankles, which prevents them from going to the emergency room, which saves taxpayers about $1.7 million.

Shareholder: Hm…

Tim Cook: Our phones have also reduced crimes by 30% in some cities, since teenagers and young adults have been using their phones to take naked butt selfies, or NBS, and to look at viral cat videos instead of robbing banks, starting gangs, or committing other crimes.

Shareholder: That’s great to hear.

Tim Cook: Would you consider renewing your stocks this coming year?

Shareholder: I’ll have to consult with the family, Tim. Our investment priorities might change this year. I’ll let you know in 9 months. But to be honest, the ROI seems kind of low with only 15% finding jobs and 7% of seniors using their iPhones to learn how to make tourniquets after they break their ankles…


At the retail store:

Customer: Hi, I’d like to buy the iPhone 8 Double Plus.

Employee: I can help you with that. What color would you like? We have black, white, or Burnished Coral?

Customer: Black. But before I buy this phone, what is your sustainability plan? How do you plan to sustain this store after I bought this phone and I’m gone? How are you diversifying your revenues so that you’re not so dependent on retail customers?

Employee: Well, we are courting government contracts, as well as developing relationships with, uh, local and national, um…

Customer: Sorry, it doesn’t seem like you’ve thought much about sustainability. It’s for Apple’s own good to diversify its revenues and not be so dependent on its customers. I’ll buy a phone later when you have that figured out.


Staff meeting:

Tim Cook: Investors are breathing down my neck about our outcomes. We need to increase the number of people, especially seniors, who use our iPhones to look things up after falling and suffering injuries. What ideas do you all have?

Angela, CFO/COO/CTO/Janitor: Our R&D is working on a feature that would automatically alert emergency services when a senior falls.

Tim Cook: Excellent. How is that going?

Angela: Only 340 customers are allowing a portion of their iPhone payments to be used on Research and Development. So we’ve been short-staffed. In fact, our entire R&D department is basically just Eduardo, who graduated last month with a Master’s in Botany, but he took several online courses on coding.

Eduardo, SVPR&D: If you think about it, plants and phones are actually a lot alike.

Tim Cook: OK…let’s keep working on that feature. Meanwhile, how is the gala planning coming along?

Steve, DD/SVPCom/QA/HR: Better than we thought, boss! Listen to this, after a bunch of discussion at the last event planning meeting, we finally came up with a cool name for the gala. At first, we thought we would just call it “The Apple Gala.” But then we thought, why not be a little cheeky and fun. So now we are calling it…“The Gala Apple.”

Tim Cook:….

Steve: Gala is a type of—

Tim Cook: I know what gala apples are! How is recruitment for table captains coming along?

Steve: We have 5 captains confirmed. Zuck says he can’t captain, but he’ll raise his paddle at the $1,000 level during the ask.


At the retail store:

Customer: Hi, I heard that you are asking for donations of gently-used lightning cables?

Apple employee: Yes, it’s for our initiative to provide charging cables to low-income individuals during the holidays

Customer: Well, I don’t have any lightning cables. But, I got a box of clothes hangers and twelve cans of beets I bought five years ago that I never got around to eating.

Employee: I’m not really sure we can use those…

Customer: I’m sure you can. Poor people love beets. I already dropped it off in your donation box. If you could send me a tax receipt, that would be swell!


At Thanksgiving

Tim Cook’s Mom: How is your job going, Timmy?

Tim Cook: It’s great, Mom. It can be stressful, but really rewarding. Our iPhones support thousands of people as they look for jobs. They also reduce crime and save taxpayers money, and help a lot of seniors when they fall and sprain their ankles.

Tim Cook’s Dad: Are you making enough money? Are you doing OK? Your mother and I are kind of worried about you, son. When will you find a real job?

Tim Cook: Mom, Dad, we’ve been through this. I’m not going to get a “real job.” Helping people IS. A. REAL. JOB! I’m making a difference in the world!

Tim Cook’s Dad: All right, no need to get defensive.

Tim Cook: I’M NOT DEFENSIVE!!!…Look, will you come to the Gala Apple next month? You can get a better picture of the work I’m doing.

Tim Cook’s Mom: We’ll check our calendar, honey. It might be your cousin’s housewarming party. Such a nice house. He’s a lawyer, you know. Have you seen his NBS at the Grand Canyon?



This blog posting was first printed June 26, 2017. It is reprinted/republished with permission.

Crunching on fresh fruits and vegetables! – June is “National Fresh Fruit & Vegetable Month”

By Kate Lythgoe, Food Programs Manager

When most people think of a food pantry they envision shelves of non-perishable items: canned fruits, vegetables, beans and boxed pasta and cereal. While Tri-Lakes Cares does have a pantry that houses those things, we also have a food program called Help Yourself that may surprise some people in what we offer.

Help Yourself is a perishable food pantry, which is run on donations through community retail partners as part of their food rescue efforts and is a no-cost program for Tri-Lakes Cares to offer.  Help Yourself contains fresh fruit and vegetables, dairy, meat and bakery products and is set up to look like a grocery store. Glass door refrigerators display milk, eggs, yogurt as well as cut and packaged fruit and vegetables. Our produce bins hold potatoes, onions, peppers, bananas, apples and oranges, to name a few.

Help Yourself allows clients to shop for themselves, as anyone would at a grocery store. They can examine the fruit, and pick the best one; they can check the dates on the yogurt to confirm they can eat it before it’s inedible.

In September of last year, our clients took a survey and at that time the most common request was that they would like to see more produce, dairy and meat. We are continually working to procure these items for our clients. We have come a long way from September, and will continue to move forward.

This month, Next Step Ministry will be constructing a garden wall on the south side of our building. This garden will grow herbs and vegetables for client use. We are constantly striving to become self-sustainable, just as we ask our clients to be while using our programs.

If you are a gardener, there are opportunities to get involved to bring more fresh fruits and vegetables to our clients:

For more information and recipes about incorporating fresh fruits and vegetables, visit the USDA website at: National Fresh Fruit and Vegetable Month



Did you know? May is National Mental Health Awareness Month!

By Paula Blair and Francisca Blanc

What is mental health? It is the way your thoughts, feelings, and behaviors affect your life. Good mental health leads to positive self-image and in turn, satisfying relationships with friends and others. Having good mental health helps you make good decisions and deal with life’s challenges at home, work, or school (American Psychological Association). However, a whole month dedicated to being aware of mental health? YES!

As Americans, we tend to be self-reliant, problem-solving enterprising people. Great for managing a career, a home, or post-secondary education. We get sick or injured; we get fixed-up and move on with our lives. Nobody would think twice about getting help to fix a broken bone or get medicine for pneumonia, would they? Would you? What about getting help when you have experienced a loss of a loved one, a pet, or a job? Or when you mentally hit a wall and can’t think straight because you have been working non-stop for several days plus managing (trying to) a personal life? That is like being mired in a mental muck with no obvious way to help yourself. You try and try and it seems as if the mental muck keeps sucking your life force away. You begin to feel desperate, overwhelmed, and not hopeful. Soon, your work-life/school-life/home-life begins to deteriorate, chunks of “you” break-off and the only things which seem to provide relief are sleep, isolation, and sometimes, high-risk behaviors. It is a dark, downward spiral. There is help!

In El Paso County, the  National Alliance on Mental Illness (NAMI), Colorado Springs chapter offers free of cost classes and support groups for individuals, family members and others to help you understand the complexities of different mental illnesses, learn how to access resources, and most importantly, connect with others who have shared experiences.

As many resources are available online, it’s important to remember that taking care of your mental illness requires medical attention as any other physical illness. Talking to your primary doctor can be the first step if you think you or someone you love suffers of mental illness. Seeking a psychiatrist and/or a therapist is a crucial next step, as mental illness requires specialized training for proper medication and therapy.

Ultimately, self-care: exercising regularly, eating healthy meals, taking the medication, and sustaining a healthy social life are all important when addressing mental health. If you or a loved one might experience mental illness and you are not sure what to do, you should talk about it with your primary doctor. Reach out to NAMI Colorado Springs by calling them at 719-473-8477. For a crisis situation, you can call the Colorado Crisis and Support Line 844-493-8255.

To learn more about Mental Health Month visit the Mental Health America.


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