What are the social determinants of health?
Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
SDOH can be grouped into 5 domains:
- Economic Stability
- Education Access and Quality
- Health Care Access and Quality
- Neighborhood and Built Environment
- Social and Community Context
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. https://health.gov/healthypeople/objectives-and-data/social-determinants-health
Social Determinants of Health
People without steady employment and who live in poverty are more likely to suffer from health issues and have limitations to the work they can perform. Many people are working but are still living below the poverty line. Many are not offered or cannot afford health insurance.
Economic stability includes employment programs, career counseling, and high-quality childcare opportunities. But there is still more that needs to be done. Subsidized payments for food, housing, health care, and education can reduce poverty and improve health and well-being. Policies at the local, state, and national levels need to be continuously evaluated and reformed
Access to quality education can be restricted for a large number of students. Children from low socioeconomic households and children with disabilities are more likely to struggle with schoolwork. They are also less likely to graduate from high school or continue with post-secondary education. Many public schools in low economic areas do not perform at the levels of schools in more affluent communities. The burden of tuition for better education or college is not even an option for many families. Even the stress of living in poverty can affect children’s brain development. Programs to help children and adolescents succeed in school and help families pay for further education have long-term health benefits
Many families do not have access to health insurance. People with no health insurance are less likely to have a primary care provider and receive recommended health care services, such as cancer screenings. Many cannot afford the tests and medications they need. Location is also key to health care. Families in remote areas may not have transportation to doctor’s offices or hospitals. Many emergency services in rural areas have extremely stretched their resources. They can transport a patient to a hospital, but if another call comes in, that patient needs to wait thirty minutes, an hour, sometimes more, for the ambulance to return and get them. This extended time can be critical to the health of the patient. Strategies to implement pathways, both face to face and remotely, to health care professionals can help more people get the care they need and save lives.
The communities and neighborhoods where families reside have a huge impact on their health and welfare. Neighborhoods with high crime rates, health risks, and safety risks are just one component. Lower-income areas may have housing with inadequate heating or no access to potable water. Work environments can also cause health concerns, such as exposure to asbestos or lead paint. Implementing policies to help reduce these risks and improve communities can promote health. Adding streetlights can help lower crime rates, and bike and walking paths can encourage exercise. These contribute to a better quality of life for all residents.
Relationships and interactions with family, friends, co-workers, and community members have a major impact on health and well-being. Obstacles and barriers that are out of a person’s control, such as unsafe neighborhoods, discrimination, or trouble affording the things they need, create negative impacts on health and safety. Positive relationships within these areas can help reduce these negative impacts. However, some individuals do not have the support they need in the home, work, or community. Interventions to help people get the social and community support they need are critical for improving health and well-being.