Social Determinants of Health

Healthy People 2030 groups the social determinants of health into five categories, with each representing a myriad of items which influence individual and community health: 

Education access and quality, which includes
- Early childhood education and development
- Graduation from high school
- Enrollment in higher education
- General educational attainment
- Language and literacy
Health care and quality, which includes
- Health insurance coverage
- Having a primary care provider
- Access to healthcare services, including distance to travel to get care
- Ability to afford care
- Getting recommended preventative care, like cancer screenings
Neighborhood and built environment, which includes
- Living in a safe or unsafe neighborhood
- Pollution of air and water
- Exposure to occupational hazards
- Access to the internet
- Affordable housing
Social and community context, which includes
- Availability of social support from family or friends
- Discrimination
- Ability to afford necessities
- Safe housing
- Language and literacy
Economic stability, which includes
- Ability to find and keep a job
- Disabilities or conditions that affect ability to work
- Ability to afford healthy food, healthcare, and housing
- Childcare

How To Assess the Health Disparities in Your Area

Looking into the health disparities in your area using the social determinants of health can inform your trainings and help your patients realize what your community is affected by. Here are a few resources to start your research:

CDC/ATSDR Social Vulnerability Index (SVI)
LexisNexis® Community Crime Map
Snohomish County Health Department’s Community Health Assessment 2022 or check your local health department’s website for their most recent community health assessment. Hospital districts or other local experts may have similar assessments available.
Check Google Maps for where hospitals and healthcare clinics are in your area. This will help you to see which communities may have to travel far to see a doctor or receive emergency health services.

The Socio-Ecological Model

The Socio-Ecological Model can help us understand how many factors affect our health. The model considers the individual, social, community, and environmental levels which all influence an individual’s ability to achieve their highest possible level of health. Let’s looks at each level:

• Individual level factors include age, education, substance use, history of abuse, and skills. Two social determinants of health which relate to this level are access to and level of education.

• Relationship level factors include a person’s family members, friends, partners, and peers. They all influence behavior and contribute to health practices. Two social determinants of health that relate here are discrimination and cohesion within a community.

• Community level factors are the physical areas around where we live, learn, work, play, and worship. Relative social determinants of health are pollution, violence, and availability of sidewalks or safe park spaces to exercise and play outside.

• Societal level factors include social and cultural norms and social policies and entail social determinants of health like economic stability and climate policies. 

When we use the Socio-Ecological Model to help us understand the social determinants of health, we can more clearly envision just how many things influence our ability to obtain our highest possible level of health.

If you would like more information about how the social determinants of health can affect a person’s health, please visit the Healthy People 2030 website. You can also watch How do social determinants impact public health? Episode 11 of “That’s Public Health” on YouTube from the American Public Health Association.