Social determinants of health

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The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status.^[1] They are the health promoting factors found in one's living and working conditions (such as the distribution of income, wealth, influence, and power), rather than individual risk factors (such as behavioral risk factors or genetics) that influence the risk or vulnerability for a disease or injury. The distribution of social determinants is often shaped by public policies that reflect prevailing political ideologies of the area.^[2]

The World Health Organization says that "the social determinants can be more important than health care or lifestyle choices in influencing health."^[3] and "This unequal distribution of health-damaging experiences is not in any sense a 'natural' phenomenon but is the result of a toxic combination of poor social policies, unfair economic arrangements [where the already well-off and healthy become even richer and the poor who are already more likely to be ill become even poorer], and bad politics."^[4] Some commonly accepted social determinants include gender, race, economics, education, employment, housing, and food access/security. There is debate about which of these are most important.^[1]

Health starts where we live, learn, work, and play. SDOH are the conditions and environments in which people are born, live, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risk. They are non-medical factors that influence health outcomes and have a direct correlation with health equity. This includes: Access to health education, community and social context, access to quality healthcare, food security, neighborhood and physical environment, and economic stability. Up to 80% of a person's health is determined by SDOH, not clinical care and genetics.

Health disparities exist in countries around the world. There are various theoretical approaches to social determinants, including the life-course perspective. Chronic stress, which is experienced more frequently by those living with adverse social and economic conditions, has been linked to poor health outcomes.^[5] Various interventions have been made to improve health conditions worldwide, although measuring the efficacy of such interventions is difficult.^[6] Social determinants are important considerations within clinical settings. Public policy has shaped and continues to shape social determinants of health.

Related topics are social determinants of mental health, social determinants of health in poverty, social determinants of obesity and commercial determinants of health.