Social determinants of health
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.
While medical care and genetics play significant roles, a person’s health outcomes are also profoundly shaped by their social, economic, and environmental conditions.
Moreover, education fosters critical thinking skills, enabling individuals to make informed decisions about their health and navigate complex healthcare systems more effectively.
Friends, family, and community networks provide emotional support, practical assistance, and a sense of belonging, which buffer against stress and contribute to mental and physical well-being.
Stable employment, living wages, and social safety nets contribute to better physical and mental health by reducing stress, enabling access to healthcare, and facilitating healthy lifestyle choices.
"[16] Identified by the 2012 World Development Report as one of two key human capital endowments, health can influence an individual's ability to reach his or her full potential in society.
[17] Yet while gender equality has made the most progress in areas such as education and labor force participation, health inequality between men and women continues to harm many societies to this day.
[20] Throughout history, transgender and non-binary (TGNB) populations have been subject to discrimination, marginalization, and violence, with limited legal representation and protections in place to support them.
In the United States, the LGBTQ+ community faces greater economic insecurity compared to their cisgender counterparts, with higher overall poverty rates, particularly among transgender people.
[24] In the study of race and health, scientists organize people in racial categories depending on different factors such as: phenotype, ancestry, social identity, genetic makeup and lived experience.
[29] Overall, racial health disparities appear to be rooted in social disadvantages associated with race such as implicit stereotyping and average differences in socioeconomic status.
[33] According to the U.S. Centers for Disease Control and Prevention, they are intrinsically related to the "historical and current unequal distribution of social, political, economic and environmental resources".
Research has found that female patients with disabilities have more infrequent mammograms as opposed to their nondisabled counterparts, leading to breast cancer being detected at later stages.
A "good job" is defined by the CDC as one that is safe and healthy; has sufficient income and benefits; allows for work-life balance; provides employment security; considers employees' voices in decision-making; offers opportunities to gain skills; and has positive employment-related relationships.
[40] Steven H. Woolf of the Virginia Commonwealth University Center on Human Needs states, "The degree to which social conditions affect health is illustrated by the association between education and mortality rates.
[46] Globalization has caused an uneven distribution of wealth and power both within and across national borders, and where and in what situation a person is born has an enormous impact on their health outcomes.
Pulse oximeters have been found to consistently overestimate the blood oxygen levels in patients with darker skin tones, which can lead to greater risk of undiagnosed hypoxemia.
In the case of the Spirometer, a device that measures lung capacity, correction factors are applied based on race, but there is no scientific evidence to suggest that this should occur.
[55] Medical devices have the potential to affect various populations, but minority and marginalized groups often face disproportionately negative impacts due to biased design.
[78] When the fight-or-flight reaction is chronically elicited in response to constant threats to income, housing, and food availability, the immune system is weakened, insulin resistance is increased, and lipid and clotting disorders appear more frequently.
The effects of chronic fight-or-flight is described in the allostatic load model[79] The materialist approach offers insight into the sources of health inequalities among individuals and nations.
[78] Comparisons to those of a higher social class can also lead to attempts to alleviate such feelings by overspending, taking on additional employment that threaten health, and adopting health-threatening coping behaviors such as overeating and using alcohol and tobacco.
[citation needed] Life-course approaches emphasize the accumulated effects of experience across the life span in understanding the maintenance of health and the onset of disease.
[85] Studies into the childhood and adulthood antecedents of adult-onset diabetes show that adverse economic and social conditions across the life span predispose individuals to this disorder.
As one example, children who enter school with delayed vocabulary are set upon a path that leads to lower educational expectations, poor employment prospects, and greater likelihood of illness and disease across the lifespan.
[93] The Commission on Social Determinants of Health made recommendations in 2005 for action to promote health equity based on three principles: "improve the circumstances in which people are born, grow, live, work, and age; tackle the inequitable distribution of power, money, and resources, the structural drivers of conditions of daily life, globally, nationally, and locally; and measure the problem, evaluate action, and expand the knowledge base.
In addition, policies to reduce child poverty are particularly important, as elevated stress hormones in children interfere with the development of brain circuitry and connections, causing long term chemical damage.
There is little evidence to suggest the efficacy of such approaches in improving the health status of those most vulnerable to illness in the absence of efforts to modify their adverse living conditions.
[127] The work of the commission was based on development goals, and thus, connected social determinants of health discourse to economic growth and bridging gaps in the healthcare system.
[127] The first imperative was to improve daily living conditions, including work and home physical environments, early childhood development and education, and social protection across the lifespan.
