What Are The Social Determinants of Health?
Written by Isabel Vasquez RD, LDN
In the media, health is often discussed as an individual endeavor. Our eating and exercise habits are held up as the most important things when it comes to health.
While focusing on these behaviors can be important not just to prevent and treat disease but also to feel good in our bodies, it leaves out an important piece of the discussion–the social determinants of health (SODH).
In this blog, learn what the SODH are, how they impact health, and the harms of leaving them out of health conversations.
What Are The Social Determinants Of Health?
The U.S. Department of Health and Human Services (USDHHS) defines the SODH as “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.”
They group them into five domains:
Economic stability
Education access and quality
Healthcare access and quality
Neighborhood and built environment
Social and community context
Each of these domains branches out into more specific subcategories.
The government has a Healthy People initiative that sets population-level goals for various public health issues. There are specific goals within Healthy People 2030 (the current iteration of the Healthy People initiative) that address each domain of the SODH.
For example, a current goal of Healthy People 2030 under the “health care access and quality” domain is “reduce the proportion of people who can’t get prescription medicines when they need them”, and one under the “social and community context” domain is "reduce bullying of transgender students”.
These are just two examples of dozens of goals set based on public health concerns related to the SODH.
Ultimately, the SDOH invites us to zoom out to look at someone’s overall life and how bigger, systemic factors impact their health.
How Do The Social Determinants Of Health Impact Health?
Education alone isn’t going to change people’s health.
Someone can have all the nutrition education in the world, but that doesn’t mean they’ll have access to grocery stores that offer a variety of health-promoting foods or that they are in a financial position to afford a variety of foods.
Health is so multi-faceted. It isn’t just about our individual behaviors; it’s about so many other factors captured by the SODH.
When we place the blame on individuals for their health issues we are potentially neglecting the larger factors impacting their health.
The Social Determinants of Health for Latines
As Latines, we are disproportionately affected by various aspects of the SDOH including community gun violence, discrimination, lower college enrollment, food insecurity, and poor access to primary care, per the USDHHS.
Yet we often hear our cultural foods being blamed for health disparities in our Latine community. Putting this in perspective is key to understanding the statistics we see about chronic disease rates–like diabetes and high cholesterol– in our communities.
We need to center the social determinants of health in health and wellness conversations.
Being able to purchase and prioritize a variety of nutritious, culturally relevant foods is often a privilege in our society. It takes financial stability, proximity to a well-stocked grocery store, and transportation.
Furthermore, there are so many other factors that impact someone’s health besides food and nutrition, such as exposure to environmental toxins, racism, and health care access. When we leave these systemic factors out of conversations about health, we aren’t doing people justice.
Unfortunately, we see this manifest as healthism (which we cover in depth in another blog), defined by Robert Crawford as, “the preoccupation with personal health as a primary—often the primary—focus for the definition and achievement of well-being; a goal which is to be attained primarily through the modification of life styles.”
By learning about the SODH, we can see that health is multifaceted, complex, and related to a lot more than just our individual behaviors.
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