Distance to the nearest hospital, household income, and access to a grocery store – what do these three things have in common? They are all social determinants of health (SDOH).
Social determinants of health are factors in one’s environment, out of one’s individual control, that can impact their health and well-being. They can include one’s physical context – for example, access to safe and reliable housing, distance to hospitals or to public schools, or access to grocery stores and nutritious foods – but can also be broader. For example, climate change and the natural environment are SDOH that can result in polluted air or lack of clean water which impacts health outcomes. Forces like racism and discrimination, as well as political and economic systems, are also SDOH, because they impact one’s daily living experiences and can have significant impacts on health and well-being. If you take a moment to think about some of the things that impact your personal health – whether you’ve bought fresh fruits or vegetables recently, if you feel safe enough in your neighborhood to go for a walk or run, how easy it is for you to make an appointment with a healthcare practitioner – you’ll likely see just how impactful these different social determinants of health are!
Social determinants of health are incredibly important to understand as they have significant and real world impacts on individual health and well-being outcomes. For example, poor rural communities in which hospitals, grocery stores, and physical activity opportunities may not be as accessible have significantly higher mortality rates compared to those in affluent rural areas – almost three times as high for Black infants and children. Individuals without consistent access to grocery stores carrying healthy foods are less likely to have good nutrition, and in turn, be at higher risk for conditions like diabetes, cardiovascular disease, and obesity, potentially lowering life expectancy and negatively impacting quality of life. Educational attainment, socioeconomic status, and race are other SDOHs that are intertwined – for example, while 52.3% of Asian Americans in 2015 had a college degree, only 20.2% of Blacks, 14.8% of Hispanics, and 14.1% of American Indians/Alaska Natives (AIANs) did. It is unsurprising then, that both poverty and unemployment rates are nearly two times higher for AIANs and Blacks than other races. This, in turn, can impact access to health insurance coverage, food security, recreational physical activity, and other resources that directly impact health outcomes.
Because these SDOH are largely out of the individual’s control, you might ask what we can do to lessen their impact. Public health organizations and their partners, including the education, transportation, and housing sectors, are taking action to improve these conditions. The Office of Disease Prevention and Health Promotion’s “Healthy People 2030” Plan focuses on SDOH specifically, working to “create social, physical, and economic environments that promote attaining the full potential for health and well-being”. For more information, you can visit https://health.gov/healthypeople/priority-areas/social-determinants-health .
References:
CDC. (2022, December 8). Social Determinants of Health. Centers for Disease
Control and Prevention. https://www.cdc.gov/about/sdoh/index.html
Singh, G. K., Daus, G. P., Allender, M., Ramey, C. T., Martin, E. K., Perry, C.,
Reyes, A. A. L., & Vedamuthu, I. P. (2017). Social Determinants of Health
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Singu, S., Acharya, A., Challagundla, K., & Byrareddy, S. N. (2020). Impact of Social
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Retrieved February 11, 2024, from
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