Introduction

Our health is shaped by many factors, but not all of them are medical. The environment in which you grow up, live, and work can significantly impact your overall health. From the availability of healthcare services to the quality of education, the conditions in which you thrive can determine your risk for various health conditions and your ability to access necessary treatments. These factors are collectively known as Social Determinants of Health (SDOH). The purpose of understanding and addressing SDOH is to reduce health disparities and work towards achieving health equity for all individuals, regardless of their background.

Understanding Social Determinants of Health (SDOH)

According to the Centers for Disease Control and Prevention (CDC), SDOH are the non-medical factors that influence health outcomes. These factors include the conditions in which people are born, grow, live, work, and age. SDOH are crucial because they affect your access to resources and opportunities that promote good health, such as education, healthcare, and stable housing.

Given the diverse conditions people face due to their social, economic, and cultural backgrounds, addressing these determinants is essential in achieving health equity. By ensuring that everyone has the opportunity to access the resources they need for a healthy life, we can work toward reducing disparities in health outcomes.

The Five Domains of Social Determinants of Health

There are five major domains within the SDOH framework, which encompass the factors that impact your overall health:

1. Economic Stability
Economic stability is critical in determining your ability to access basic needs such as food, housing, and healthcare. Financial resources allow individuals to live in safe conditions, pay for medical treatments, and enjoy a healthy lifestyle. Unfortunately, not everyone has access to financial stability. In the U.S., 10% of people live in poverty, struggling to meet basic needs. Factors that contribute to economic instability include:

  • Disabilities: People living with disabilities may face challenges in finding or maintaining employment, leading to limited access to healthcare and proper treatment.

  • Housing Instability: When individuals lack stable housing, it can contribute to physical and mental health issues, including high blood pressure and anxiety.

  • Food Insecurity: The inability to regularly access nutritious food can lead to malnutrition, obesity, and chronic diseases like diabetes.

2. Education Access and Quality
Education is a key determinant in improving overall health. Quality education opens doors to better employment opportunities, which in turn, enables people to live healthier lives. However, many individuals face barriers to accessing quality education, particularly in underserved communities. Issues such as bullying, financial constraints, and single-parent households can hinder one's ability to achieve academic success, which may lead to long-term health implications. Those without a high school diploma or higher education may face poorer health outcomes and reduced life expectancy.

3. Healthcare Access and Quality
The quality of healthcare and access to it significantly influences health outcomes. Regular check-ups, preventive screenings, and proper medical treatments are essential to maintaining good health. However, millions of people face barriers to accessing healthcare. Many individuals lack health insurance or live in rural areas without access to healthcare facilities. Transportation issues and the inability to afford medical services exacerbate these challenges. Inadequate healthcare access can delay diagnosis, increase the risk of complications, and contribute to higher mortality rates.

4. Neighborhood and Built Environment
Where you live has a profound effect on your health. Living in a safe and supportive neighborhood provides access to resources like healthcare, education, and community support. However, some communities, especially those with low-income populations or people of color, are more likely to face environmental hazards such as pollution, crime, and limited access to healthcare. These conditions can lead to physical and mental health issues, such as respiratory diseases due to pollution or stress-related disorders from living in violent neighborhoods.

  • Violence: Communities with high crime rates can increase the risk of injury and mental health issues such as anxiety and PTSD.

  • Pollution: Living near major roadways, industrial sites, or other sources of pollution can lead to chronic diseases like asthma and cardiovascular disease.

  • Secondhand Smoke: Exposure to tobacco smoke increases the risk of lung diseases and heart disease, even for non-smokers.

5. Social and Community Context
A supportive social network is crucial for maintaining good health. Positive relationships with family, friends, and community members provide emotional support and can help people cope with life’s challenges. However, discrimination, social isolation, and other negative social factors can contribute to poorer mental and physical health outcomes. Racial discrimination, for instance, can increase stress levels and contribute to diseases such as high blood pressure and heart disease. Additionally, individuals with low health literacy or those who face language barriers may struggle to access healthcare and understand medical instructions.

Health Inequities and Disparities

SDOH contribute to health inequities—systemic differences that affect certain groups' ability to achieve optimal health. These disparities often disproportionately affect marginalized communities, including people of color, low-income populations, individuals with disabilities, and LGBTQ+ communities. For example, racial and ethnic minorities may experience more barriers to accessing healthcare, healthier food options, and safe housing. These inequities worsen health outcomes and lead to higher rates of chronic conditions, lower life expectancy, and higher levels of stress and anxiety.

Addressing Health Disparities and Moving Toward Health Equity

While there are numerous challenges related to SDOH, efforts are underway to reduce health disparities and improve access to resources. Programs like Healthy People 2030 are helping to set national objectives aimed at improving health literacy, reducing discrimination, and increasing access to health screenings. Other initiatives like Mobilizing for Action through Planning and Partnerships (MAPP) work with communities to address local health issues and create positive change.

Conclusion

Social determinants of health are powerful factors that shape health outcomes. Economic stability, education, healthcare access, the neighborhood environment, and social context all play a vital role in determining one's overall well-being. Addressing these determinants through focused initiatives and policies can help reduce health disparities and promote health equity for all. By ensuring that everyone has access to the resources they need, we can build healthier, more resilient communities.