Social determinants of health
Social determinants of health
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Social determinants of health

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Social determinants of health

Social determinants of health (SDOH) are the factors, oftentimes related to environment or status, that affect the conditions of daily life and one's health. They are the factors that determine a persons vulnerability for disease but also their ability to gain access to care. They are usually broken down into five categories: Economic Stability, Education, Social and Community Context, Health Care Access, and Built Environment.

The World Health Organization says that "the social determinants can be more important than health care or lifestyle choices in influencing health." 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." 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.

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. Studies have found that more than half 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. Various interventions have been made to improve health conditions worldwide, although measuring the efficacy of such interventions is difficult. 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.

The United States Centers for Disease Control and Prevention (CDC) defines social determinants of health as "life-enhancing resources. In the realm of public health, the concept of social determinants of health (SDOH) has emerged as a crucial framework for comprehending the myriad factors that influence an individual's well-being. While medical care and genetics play significant roles, a person's health outcomes are also profoundly shaped by their social, economic, and environmental conditions. Understanding these determinants is imperative for devising effective strategies to address health disparities and promote equitable access to healthcare. Some of the main social factors that shape one's health include Socioeconomic Status (SES), education, neighborhood and physical environment, social support networks, healthcare access and quality, and economic stability.

As per findings from the Center for Migration Studies of New York, there exists a strong correlation among various social determinants of health. Individuals residing in regions marked by one specific determinant often experience the impact of other determinants as well. These social determinants significantly shape health-promoting behaviors, emphasizing that achieving health equity across populations necessitates a fair distribution of these social determinants among different groups.

A commonly used model that illustrates the relationship between biological, individual, community, and societal determinants is Whitehead and Dahlgren's model originally presented in 1991 and subsequently adapted by the CDC. Additionally, within the United States, Healthy People 2030 is an objective-driven framework which can guide public health practitioners and healthcare providers on how to address social determinants of health at the community level. A recent scoping review that evaluated the intensity and complexity of social needs interventions found limitations exist in scaling them, as the majority of studies have not identified causal inferences about individual components.

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