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As a pediatrician, Dr. James D. Marshall understands the significance of identifying and addressing social determinants of health when treating patients. Determinants are nonmedical factors that influence health and well-being that individuals are unable to directly control, including income, education, physical environment and genetics.“When someone is unable to conquer an illness, there’s a barrier that medical care is not going to ever be able to navigate,” Marshall said. “There’s some social determinant in their past that’s put them in that place.”The inaugural Fort Worth Health & Wellness Symposium at Texas Christian University April 14 tackled the topic head-on. The symposium was a collaboration between TCU’s AddRan College of Liberal Arts, The Renaissance House of Terrell Heights and Cigna Healthcare. Located in the Historic Southside, The Renaissance House opened in 2024 to provide community health and neighborhood education to residents of 76104, which reported the lowest life expectancy in Texas in 2019 despite housing the city’s Medical District. The TCU event brought together The Renaissance House’s consortium members and Fort Worth community members to discuss factors that influence citywide health and wellness. Local physicians also provided community health updates and presented how the recent measles outbreak in Texas is shaped by social determinants. “Everything around health care — education, family, food security — there’s a whole gamut of things that help pour into the health of an individual outside of general health and welfare,” Marnese Elder, co-founder of The Renaissance House, said. During a panel about holistic health, Dr. Tricia Elliott and Dr. Demequa Moore discussed how they consider the social determinants of health in their practices to build trust and confidence when treating patients.  As a trainer and educator of medical students, Elliott said she emphasizes the biopsychosocial model of care, which addresses biological, clinical, psychological and social factors to diseases. For example, food insecurity can influence hypertension, she said.“Every disease, you need to be asking: What are those other factors? What’s that upstream effect that’s happening to cause this?” Elliott said. “When they leave the room with their patient, I always ask my learners: ‘Did you get to know the patient? Did you see them? Did you hear them?’”Elder said it was the most important discussion of the day.“The doctors knew that everyone here should be educated on what those determinants are and what’s the most impactful way to bring forward the resources that are needed to address them,” Elder said. Doctors call to improve vaccination rate amid measles outbreakAdditionally, Marshall presented statistics about measles and vaccination rates as a call-to-action for Tarrant County. The 2025 measles outbreak in Texas is part of a broader resurgence of the virus in the U.S. because of incomplete vaccination coverage as well as vaccine hesitancy and abandonment, Marshall said. The percentage of students with more than one conscientious vaccine exemption on file in both public and private schools in Texas more than doubled between 2018 and 2022. During the 2018-19 school year, the rate was 1.2%. In the 2021-22 school year, it was 2.7%.“This is effectively an intentional acquisition of a disease that used to no longer scourge our population,” Marshall said. Jennifer Giddings Brooks, co-founder of The Renaissance House, said she was pleased that public health data was presented during the symposium so attendees could see the numbers in black and white. “Sometimes, you just need to see it in your face and hopefully people will pay attention,” Brooks said.That data validated the panel discussions about social determinants from a social services standpoint, Elder said, and the information will help impact the health needs of Fort Worth.Culture sets health’s social determinants, Marshall said. He said it is the job of the modern medical community to pinpoint and correct social determinants that are damaging patients early on in their lives.“I’m determined to pick apart the factors that are making kids become critically ill, like anti- vaccination, and try to right those wrongs so kids don’t have to suffer the critical illness that I took care of for all those decades,” Marshall said. Kathryn Miller is a reporting fellow at the Fort Worth Report. You can contact her at kathryn.miller@fortworthreport.org. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.