Social determinants of health (SDOH) are the conditions in which people are born, grow, work, live, and age. They are shaped by the distribution of money, power, and resources at global, national, and local levels. The World Health Organization has stated that SDOH are responsible for the majority of health inequities. Despite this, SDOH are often left out of public health discussions. This is a problem because, without addressing SDOH, we can only make a dent in
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Why social determinants of health matter
There is growing recognition that health is determined by more than access to quality health care. Rather, health is determined by a complex combination of factors, including economic stability, education, housing, social support networks, and access to transportation and healthy food. These social determinants of health (SDOH) play a significant role in our nation’s overall health and well-being.
The Centers for Disease Control and Prevention (CDC) defines SDOH as “conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.”1 SDOH have a complex relationship with health; they do not operate in isolation from each other or from individual-level risk factors (such as behaviors). Rather, they combine synergistically to shape overall health outcomes.
Why social determinants of health matter
Addressing SDOH is critical to achieving optimal population health and well-being. This is because they are largely responsible for significant disparities in health outcomes that exist across the United States. For example, life expectancy at birth for Blacks is 3.5 years shorter than for Whites.2 Additionally, the infant mortality rate for Blacks is more than 2 times the rate for Whites—11.0 compared with 4.9 per 1,000 live births in 2018.3 SDOH also play a role in other key measures of population health such as self-reported physical and mental health status and functional limitations due to chronic conditions such as arthritis.4
Further compounding these disparities are the coronavirus disease 2019 (COVID-19) pandemic and resulting economic downturn, which have disproportionately impacted communities of color and other vulnerable populations who already experience an inequitable burden of poor health outcomes.5 For example, while Blacks make up 13% of the U.S. population, they account for 23% of COVID-19 cases and 30% of deaths 6—a disparity that exists even after accounting for underlying risk factors such as diabetes mellitus and hypertension.7 The pandemic has also exacerbated pre-existing disparities in mental health; a Kaiser Family Foundation survey found that adults in households with lower incomes (<$40,000) or who identify as Black or Hispanic are more likely to report anxiety or depression since the start of the pandemic compared with those in higher-income households or who identify as White (43%, 41%, 29%, respectively).8
How poverty affects health
There is a strong link between poverty and poor health. Poverty can affect health in many ways. It can limit access to medical care, healthy foods and safe housing. It can lead to stress and anxiety. It can also cause people to engage in risky behaviors, such as using drugs or not wearing a seatbelt.
Poverty is also a risk factor for chronic diseases such as heart disease, stroke and diabetes. This is because poor people are more likely to have unhealthy lifestyles. They are also less likely to be able to afford medical care or treatment for chronic diseases.
The good news is that there are ways to reduce the effects of poverty on health. Increasing access to medical care, healthy food and safe housing can improve health outcomes for people living in poverty.
The role of education in health
There is a growing body of evidence that suggests that education is a social determinant of health. A number of studies have shown that higher levels of education are associated with better health outcomes. For example, one study found that people with higher levels of education are more likely to have lower rates of cardiovascular disease.
There are a number of possible explanations for this link between education and health. One possibility is that educated people are more likely to have better-paying jobs, which gives them access to better healthcare. Another possibility is that educated people are more likely to be aware of healthy lifestyle choices, such as eating a balanced diet and exercising regularly.
It is clear that education plays a role in health, but it is also important to remember that other social factors, such as income and housing, are also important determinants of health. In order to truly improve the health of the population, we need to address the social determinants of health in a comprehensive way.
The impact of housing on health
There is a growing body of evidence that summarizes the impact of housing on health. A lack of affordable, quality housing can lead to a number of adverse health outcomes, including mental health issues, chronic diseases, and increased risk of injury. In addition, poor housing can be a major source of stress, which can further exacerbate existing health problems.
There are a number of factors that contribute to the relationship between housing and health. For instance, substandard housing may have mold or other environmental hazards that can trigger asthma or other respiratory problems. In addition, individuals who live in poverty are more likely to live in overcrowded or unsafe housing conditions. These conditions can lead to an increase in the spread of illness, as well as an increased risk of injury.
It is important to note that the relationship between housing and health is complex and multi-layered. There are a number of social determinants of health that play a role in this relationship. For instance, poverty is a major factor that contributes to poor housing conditions. Other social determinants of health include race/ethnicity, gender, education level, and employment status.
There are a number of ways to address the social determinants of health that contribute to poor housing conditions. One way is to provide subsidies or other financial assistance to help low-income individuals afford safe and quality housing. Another way is to develop and implement policies and programs that improve access to affordablehousing. Additionally, community-based organizations can play a role in addressing the social determinants of health by providing support and resources to individuals living in poverty or substandard housing conditions.
The importance of transportation in health
Transportation is a critical social determinant of health. It can impact an individual’s ability to access healthcare, nutritious food, and their overall quality of life. According to the CDC, “lack of transportation is a significant barrier to health care,” and this is especially true for rural and low-income populations.
There are a number of ways to improve transportation options in communities. These include increasing public transportation options, improving pedestrian and bicycle infrastructure, and creating “transportation demand management” programs that discourage single-occupancy vehicle use.
Improving transportation options can have a significant impact on public health, and it is an important part of achieving health equity.
The influence of food insecurity on health
Food insecurity, which is defined as “the state of being without reliable access to a sufficient quantity of affordable, nutritious food”1, is a significant social determinant of health. In the United States, it is estimated that 14.3% of households are food insecure, which equates to nearly 50 million people.2 Households with children are more likely to be food insecure, as are households headed by single mothers or someone with a disability.2
There are many health consequences associated with food insecurity, including obesity, diabetes, high blood pressure, and depression.3–5 For children, food insecurity is linked to poorer educational outcomes and increased behavioral problems.6
Given the significant negative impact that food insecurity has on health, it is important to identify interventions that can address this issue. One promising intervention is the Supplemental Nutrition Assistance Program (SNAP), which is the largest anti-hunger program in the United States.7 SNAP provides financial assistance to low-income households to help them purchase food.8
A recent study found that households participating in SNAP had a significantly lower risk of food insecurity compared to non-participating households.9 This suggests that SNAP may be an effective intervention for reducing food insecurity and improving health outcomes.
The role of racism in health
There is a huge body of research that has shown the role of racism in health. Racism can be defined as prejudice, discrimination, or antagonism directed against someone of a different race based on the belief that one’s own race is superior. Racism can take many forms, from individual acts of hatred or bigotry to systemic discrimination in institutions like education, employment, housing, and healthcare.
Studies have shown that racism is a major stressor that can lead to a variety of health problems. Racism can cause cardiovascular problems, chronic pain, anxiety, depression, post-traumatic stress disorder, and more. It can also lead to pregnancy complications and birth outcomes like preterm birth and low birth weight.
There is no easy fix for racism, but there are things that can be done to address it. Education is one key way to combat racism. By increasing understanding of the issue and its effects on health, we can start to change perceptions and create more inclusive environments. Another way to address racism is through policy change. We need laws and regulations that protect people from discrimination and provide equal opportunity for everyone. Finally, we need to support organizations and initiatives that are working to end racism.
The effect of sexism on health
The effect of sexism on health is well-documented. Studies have shown that sexism can lead to poorer physical and mental health for both women and men. It can also lead to disparities in health care, with women more likely to receive less effective care than men.
There are a number of ways to address the issue of sexism in healthcare. One is to increase access to care for all people, regardless of gender. Another is to provide training for healthcare providers on how to recognize and address sexist attitudes and behaviors. Finally, it is important to educate the public on the importance of gender equality in healthcare.
The impact of homophobia on health
There is a growing body of evidence that suggests that homophobia can have a negative impact on health. Studies have shown that gay men are more likely to experience anxiety, depression and other mental health problems, and are also more likely to engage in risky behaviors such as drug use and unprotected sex.
Homophobia can also lead to social isolation and self-imposed isolation, which can further exacerbates mental health problems. Additionally, homophobia can prevent people from seeking out medical care or from disclosing their sexual orientation to their healthcare providers, which can lead to poorer health outcomes.
So what can be done to fix these social determinants of health? Well, first and foremost, it is important to create a more inclusive and accepting society. This means working to reduce discrimination against LGBT people in all areas of life, including in the workplace, in housing, in education and in healthcare.
It is also important to provide better support for LGBT people who are experiencing mental health problems. This includes making sure that there are adequate mental health services available, and that these services are affordable and accessible. Additionally, it is important to provide training for healthcare providers so that they are better equipped to deal with the unique needs of LGBT patients.
The importance of social support in health
Social support is a huge determinant of health. It has been linked with better mental and physical health, lower stress levels, and increased longevity. There are many ways to get social support, such as through family, friends, religious groups, or community organizations. If you’re feeling isolated or unsupported, there are many resources available to help you find social support.