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Social Determinants of Health: How your place of birth can affect your health

Social determinants of health, according to KFF, are the conditions in which people are born, grow, live, work, and age that shapes the health status of individuals within the population. Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care. There are a growing number of initiatives to address social determinants of health within and outside of the healthcare system.

Addressing social determinants of health is important for improving health and reducing health disparities. Though health care is essential to health, it is a relatively weak health determinant. Research shows that health outcomes are driven by an array of factors, including underlying genetics, health behaviors, social and environmental factors, and health care. While there is currently no consensus in the research on the magnitude of the relative contributions of each of these factors to health, studies suggest that health behaviors, such as smoking, diet, and exercise, and social and economic factors are the primary drivers of health outcomes, and social and economic factors can shape individuals’ health behaviors. For example, children born to parents who have not completed high school are more likely to live in an environment that poses barriers to health such as lack of safety, exposed garbage, and substandard housing. They also are less likely to have access to sidewalks, parks or playgrounds, recreation centers, or a library. Further evidence shows that stress negatively affects health across the lifespan and that environmental factors may have multi-generational impacts. Addressing social determinants of health is not only important for improving overall health but also for reducing health disparities that are often rooted in social and economic disadvantages.

According to WHO, the social determinants of health (SDH) are the non-medical factors that influence health outcomes. The SDH has an important influence on health inequities – the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health, and illness follow a social gradient: the lower the socioeconomic position, the worse the health.

The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways: Income and social protection, education, unemployment, and job insecurity, working life conditions, food insecurity, housing, basic amenities, and the environment, early childhood development, social inclusion and non-discrimination, structural conflict, access to affordable health services of decent quality.

Research shows that social determinants can be more important than health care or lifestyle choices in influencing health. For example, numerous studies suggest that SDH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector. Addressing SDH appropriately is fundamental for improving health and reducing longstanding inequities in health, which requires action by all sectors and civil society.

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