Social Determinants of Health (SDOH)
The conditions in the environments in which 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.
Most people intuitively understand that social, economic, and environmental factors, known as social determinants of health (SDOH), profoundly influence our health. Healthy People 2030, an initiative of the Department of Health and Human Services (HHS), defines the SDOH as “conditions in the environments in which 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” (Healthy People).
SDOH can act directly or indirectly; for example, living near major roads can cause respiratory illnesses, disproportionately affecting people of color and low income populations, and neighborhoods with high crime can deter going outside to exercise. For better or for worse, these factors play a serious role in our health: an estimated 70% of premature deaths are caused by SDOH-related factors.
Healthy People 2020 identified five key areas of determinants:
economic stability (employment, housing stability, food security and access, poverty);
education (early childhood development, high school graduation, literacy);
social and community context (incarceration, social cohesion, civic participation, and systemic discrimination particularly against people of color, women, LGBTQ+, older adults, and people with disabilities);
health and health care (access to health care, access to primary care, health literacy); and
neighborhood and built environment (crime and violence, environmental conditions, housing conditions).
Recognizing these SDOH can challenge our conventional understandings of public health and what it means to protect it.