Social Determinants of Health: Definition, Influence, Outcomes

Unlocking the impact of social determinants of health: Explore their definition, influence, and outcomes for a healthier future.

Published On

February 21, 2024

Understanding Social Determinants of Health

In order to comprehend the impact of social determinants of health (SDOH), it is vital to first understand their definition and influence on individual well-being.

Definition of Social Determinants of Health

Social determinants of health refer to the conditions in the environments where people are born, live, learn, work, play, worship, and age. These conditions significantly influence a wide range of health outcomes, functioning, and quality-of-life risks [1]. Factors such as economic stability, neighborhood and physical environment, education, food, community and social context, and the healthcare system are all encompassed within the concept of social determinants of health [1].

Influence of Social Determinants of Health

Social determinants of health have a substantial impact on various health outcomes, accounting for an estimated 80% of an individual's overall health. The environments in which people live, work, and play greatly influence the quality of healthcare and health outcomes they experience. For example, access to nutritious food plays a crucial role in individuals' nutrition and overall health. People without access to grocery stores offering healthy foods are more likely to have poor nutrition, increasing their risk of health conditions such as heart disease, diabetes, obesity, and even lower life expectancy compared to those with access to healthy foods.

Addressing social determinants of health is essential to advancing health equity and improving health outcomes for all populations. Collaborative efforts among public health organizations and partners in sectors like education, transportation, and housing are necessary to improve the conditions in people's environments and reduce health disparities associated with social determinants of health.

By recognizing and addressing the social determinants of health, we can create social, physical, and economic environments that promote optimal health and well-being for everyone. This commitment is evident in initiatives like Healthy People 2030, which focuses on creating a comprehensive approach to address social determinants of health and achieve health equity [2]. Workgroups within Healthy People 2030, including the Social Determinants of Health Workgroup, are actively developing objectives related to social determinants of health, emphasizing the importance of addressing upstream factors to improve health and reduce health disparities.

Key Factors of Social Determinants of Health

To truly understand the impact of social determinants on health outcomes, it's important to examine the key factors that contribute to these determinants. The social determinants of health include various aspects of a person's life that can significantly influence their overall well-being. The key factors of social determinants of health are economic stability, neighborhood and physical environment, education, food, community and social context, and the healthcare system.

Economic Stability

Economic stability plays a crucial role in determining an individual's health. Factors such as income, employment, and access to resources directly impact a person's ability to afford healthcare, nutritious food, safe housing, and other essential resources. Those with lower socioeconomic status often face higher levels of stress, limited access to quality healthcare, and increased exposure to environmental risks, which can negatively affect their health outcomes.

Neighborhood and Physical Environment

The neighborhood and physical environment in which individuals reside can significantly influence their health. Access to safe and affordable housing, clean air and water, parks, and recreational facilities can promote physical activity and overall well-being. Conversely, living in neighborhoods with limited resources, high crime rates, environmental pollution, and inadequate infrastructure can contribute to poor health outcomes.

Education

Education is a vital determinant of health. Higher levels of education are associated with improved health outcomes, as education provides individuals with knowledge, skills, and opportunities to make informed decisions about their health. Education also impacts employment prospects and income levels, which in turn influence access to healthcare and other resources that promote well-being.

Food

Access to nutritious and affordable food is essential for maintaining good health. Food insecurity, which occurs when individuals lack reliable access to sufficient quantities of nutritious food, can lead to malnutrition, chronic conditions, and poor health outcomes. Disparities in food availability and quality can disproportionately affect marginalized communities, contributing to health inequities.

Community and Social Context

The community and social context in which individuals live significantly shape their health outcomes. Social support systems, community engagement, and social cohesion can promote physical and mental well-being. Conversely, social isolation, discrimination, and limited social networks can lead to increased stress, poorer mental health, and overall reduced quality of life.

Healthcare System

The healthcare system plays a critical role in addressing health needs and outcomes. Access to affordable and quality healthcare services, including preventive care, screenings, and treatment options, is essential for maintaining and improving health. Disparities in healthcare access and quality can contribute to health inequities among different populations.

Understanding and addressing these key factors of social determinants of health is crucial for promoting health equity and improving health outcomes for all individuals. Collaborative efforts across sectors, including public health, education, housing, and healthcare, are essential for creating supportive environments that address these factors and reduce health disparities.

Impact of Social Determinants of Health on Health Outcomes

The social determinants of health (SDOH) play a significant role in shaping health outcomes. These factors encompass the conditions in the environments where people are born, live, learn, work, play, worship, and age, and they have a profound influence on a wide range of health, functioning, and quality-of-life outcomes and risks. Let's explore some specific impacts of social determinants of health on health outcomes.

Health Disparities and Inequities

SDOH contribute to health disparities and inequities among different populations. Factors such as economic stability, access to healthcare, and neighborhood conditions can lead to significant disparities in health outcomes. Individuals facing social disadvantage, such as limited access to resources and opportunities, are more likely to experience poorer health outcomes compared to those with greater social advantages. These disparities highlight the importance of addressing social determinants to achieve health equity.

Influence on Chronic Diseases

SDOH have a substantial impact on the development and management of chronic diseases. For example, economic stability plays a crucial role in determining access to healthcare services and the ability to afford medications and treatments. Neighborhood and physical environment factors, such as access to nutritious food and safe recreational spaces, can influence the prevalence of chronic diseases like heart disease, diabetes, and obesity.

Research has shown that individuals who lack access to grocery stores with healthy food options are at a higher risk of developing health conditions associated with poor nutrition. This includes an increased risk of heart disease, diabetes, obesity, and even lower life expectancy relative to those with access to healthy foods.

Effects on Life Expectancy

The social determinants of health have a significant impact on life expectancy. Factors such as socioeconomic status, education, and access to healthcare play crucial roles in determining an individual's overall health and longevity.

Research conducted by the Centers for Disease Control and Prevention (CDC) suggests that SDOH account for an estimated 80% of an individual's overall health. The conditions in which people live, work, and play greatly influence the quality of healthcare they receive and subsequently impact their life expectancy.

By understanding the impact of social determinants of health on health outcomes, we can work towards addressing these disparities and promoting health equity. It is essential to recognize the influence of SDOH and develop comprehensive strategies to create supportive environments, ensure access to quality healthcare, and promote individual and broader interventions. By addressing the root causes of health disparities, we can strive towards a healthier and more equitable society.

Addressing Social Determinants of Health

To improve population health, reduce health disparities, and achieve health equity, it is crucial to address the social determinants of health. By focusing on these factors, we can advance health equity and improve health outcomes for all populations. This section will explore three key aspects of addressing social determinants of health: promoting health equity, taking action in various sectors, and the role of Healthy People 2030.

Promoting Health Equity

Promoting health equity involves ensuring that everyone has a fair and just opportunity to be as healthy as possible. This requires addressing the social, economic, and environmental factors that contribute to health disparities. Strategies to promote health equity include:

  • Eliminating barriers to accessing quality healthcare services.
  • Reducing disparities in access to resources such as nutritious food, safe housing, and quality education.
  • Advocating for policies that support equitable distribution of resources and opportunities.
  • Engaging communities in decision-making processes to address their unique needs.

By prioritizing health equity, we can work towards creating a society where everyone has the opportunity to achieve their highest level of health and well-being.

Action in Various Sectors

Addressing social determinants of health requires collaboration and action across multiple sectors. Public health organizations, in partnership with sectors such as education, transportation, housing, and more, play a vital role in improving the conditions in people's environments and addressing health disparities related to social determinants of health. Some examples of actions in various sectors include:

  • Education: Ensuring equal access to quality education, promoting health literacy, and providing comprehensive school health programs.
  • Transportation: Improving transportation infrastructure and access to reliable and affordable transportation options to enhance healthcare access and opportunities for physical activity.
  • Housing: Promoting affordable and safe housing, reducing homelessness, and addressing environmental hazards in housing.
  • Employment: Advancing policies that support fair wages, work-life balance, and safe working conditions.

By working together across sectors, we can create supportive environments that foster health and well-being for all individuals and communities.

Healthy People 2030 and Social Determinants of Health

Healthy People 2030, a national initiative led by the U.S. Department of Health and Human Services, has a strong focus on addressing social determinants of health. The initiative aims to create social, physical, and economic environments that promote attaining the full potential for health and well-being for all. Within Healthy People 2030, the Social Determinants of Health Workgroup and other workgroups were created to develop objectives specifically related to social determinants of health. This highlights the recognition of the importance of "upstream" factors in improving health and reducing health disparities.

By incorporating social determinants of health into the Healthy People 2030 framework, the initiative aims to guide actions, policies, and interventions that address the root causes of health disparities and promote health equity.

Addressing social determinants of health is essential for improving health outcomes and achieving health equity. By promoting health equity, taking action in various sectors, and incorporating social determinants of health into initiatives like Healthy People 2030, we can work towards creating a healthier and more equitable society for all.

Global Perspective on Social Determinants of Health

Understanding the global perspective on social determinants of health is crucial for addressing health disparities and promoting health equity. The World Health Organization (WHO) emphasizes the impact of social determinants on health outcomes, stating that they are non-medical factors that influence health by shaping the conditions in which people are born, grow, work, live, and age. Let's delve into some key aspects of the global perspective on social determinants of health:

World Health Organization's Focus

The WHO recognizes the significant influence of social determinants on health and aims to address them through various initiatives. The organization focuses on three critical areas of action: improving daily life conditions, addressing the structural drivers of health inequalities, and expanding knowledge and public awareness on social determinants of health. By targeting these areas, the WHO aims to reduce health disparities and promote health equity on a global scale.

The Social Gradient

Research indicates that health and illness follow a social gradient, where individuals with lower socioeconomic positions experience worse health outcomes. This means that the disparities in health outcomes are not limited to extreme poverty but exist across a range of income levels. Even in affluent countries like Canada, income plays a crucial role in determining health outcomes and access to other social determinants of health. Understanding and addressing this social gradient is essential for promoting health equity and reducing health inequities globally.

Social Inclusion and Exclusion

Social inclusion and exclusion play significant roles in determining health outcomes. Lack of access to essential resources and opportunities can negatively impact health. For example, limited social connections for individuals with mental health issues or isolation for the elderly can have adverse effects on their overall well-being. Promoting social inclusion and reducing exclusion are vital strategies for improving health outcomes and fostering a more equitable society.

Role of Education

Education plays a pivotal role in determining an individual's health status. Higher educational attainment is associated with better health outcomes and access to resources. Education provides opportunities for less hazardous jobs, reduces the risks of workplace injuries, and offers access to health insurance and retirement plans. Moreover, education enhances health literacy, enabling individuals to understand and navigate healthcare services effectively, empowering them to take control of their health.

Government Policies

Governmental social policies have a direct impact on the social determinants of health. Decisions related to regulatory legislation, funding allocation for social programs, employment laws, and access to critical resources like healthcare, housing, and food can significantly influence health outcomes. Government policies are instrumental in promoting health equity, reducing health inequalities, and creating an environment that supports the well-being of all individuals.

Considering the global perspective on social determinants of health allows for a comprehensive understanding of the complex factors that influence health outcomes. By addressing these determinants and promoting health equity, we can work towards a more inclusive and healthier world for all.

Strategies for Improving Health Outcomes

Improving health outcomes requires a multifaceted approach that addresses the social determinants of health. Here are three key strategies that can contribute to better health outcomes for individuals and communities:

Training Healthcare Workers

Training healthcare workers to address the social determinants of health is considered one of the key principles for promoting more equitable health outcomes for patients, families, and communities. Healthcare professionals play a vital role in identifying and addressing the social factors that influence health. By incorporating social determinants of health into their practice, they can better understand the unique challenges faced by individuals and provide tailored care and support.

Through specialized training programs, healthcare workers can develop the knowledge and skills necessary to address social determinants of health effectively. This may involve learning about community resources, social support networks, and referral systems that can help individuals overcome barriers to health. By understanding the impact of social factors on health outcomes, healthcare workers can provide comprehensive care that goes beyond treating symptoms and addresses the root causes of health disparities.

Creating Supportive Environments

In addition to individual counseling, broader interventions are needed to create supportive environments that make healthy choices the easy choices [5]. Creating environments that promote health and well-being is crucial for improving health outcomes. This can include initiatives such as urban planning to create parks and bicycle paths, improving access to healthy foods in underserved communities, and ensuring safe and affordable housing options.

By implementing policies and programs that support healthy living, communities can empower individuals to make positive lifestyle choices. Access to safe recreational spaces, nutritious food options, and affordable healthcare facilities are all essential components of a supportive environment. Collaborative efforts between government agencies, community organizations, and healthcare providers are necessary to create sustainable changes that positively impact health outcomes.

Individual and Broader Interventions

Addressing social determinants of health requires both individual and broader interventions to create supportive environments that promote healthy choices. While healthcare professionals play a vital role in addressing social determinants at an individual level, systemic changes are needed to address the underlying social factors that contribute to health disparities.

Individual interventions may involve providing education, resources, and support to individuals to help them overcome barriers to health. This can include connecting individuals to social services, assisting with financial resources, and providing education on healthy lifestyle choices.

Broader interventions, on the other hand, focus on creating systemic changes that address the social determinants of health on a larger scale. This can involve advocating for policy changes, improving access to quality education, promoting income equality, and addressing systemic racism and discrimination.

By combining individual and broader interventions, communities can work towards creating a healthier and more equitable society.

Improving health outcomes requires a comprehensive approach that addresses the social determinants of health. By training healthcare workers, creating supportive environments, and implementing individual and broader interventions, we can take significant steps towards improving health outcomes and reducing health disparities.

References

[1]: https://www.cdc.gov/about/sdoh/addressing-sdoh.html

[2]: https://health.gov/healthypeople/priority-areas/social-determinants-health

[3]: https://www.who.int/health-topics/social-determinants-of-health

[4]: https://www.cpha.ca/what-are-social-determinants-health

[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5135524/