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The social determinants of health: why they matter to improving health outcomes

Social determinants have a major impact on health outcomes – especially for the most vulnerable populations. Factors such as education, income level, and environment must be considered when providing treatment to achieve better health outcomes in these populations. The Kaiser Family Foundation noted in recent research that nearly 50 studies have found that social and structural factors, including education, race, social support, and poverty accounted for over a third of total deaths in the United States in a year. These findings make the case for policy makers, providers, and payers to consider a more holistic, comprehensive approach to healthcare for the patients and families they serve.

The impact of social determinants of health

It has been well-established that poverty inhibits access to healthy foods and safe neighborhoods, and that higher levels of education influence better health. The impact of such factors on health is defined by Healthy People 2030 as the social determinants of health.

Social determinants of health (SDOH) are 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.

- Healthy People 2030

When resources are available to address these social and economic conditions, they can have a significant positive impact on individual health outcomes and population health. Recent studies reveal when such resources are lacking, SDOH can impact both an individual’s knowledge about healthcare and resources, and limit access to them.

Social determinants & COVID-19 

Nine months into the nationwide COVID-19 vaccine roll-out, the most vulnerable communities in the U.S. still have a lower vaccination rate on average than the nation's least vulnerable. The American Rescue Plan provided $1.9 trillion in funding to address the ongoing health and economic effects of the pandemic. Some of the provisions in the American Jobs Plan included additional funding not only to address the public health crisis of the pandemic, but also called for additional funds that could address SDOH, including workforce development and wage increases, efforts targeted to affordable housing, and climate policy changes to address environmental safety.

COVID-19 has amplified the discussion around critical health disparities and inequities that have plagued the U.S. and its most vulnerable patient populations for generations. Prior to the pandemic, there were a variety of initiatives to address social determinants of health both in the public and private sectors. The COVID-19 pandemic exacerbated already existing health disparities for a broad range of populations, but specifically for communities of color.

As a result, the healthcare industry has accelerated its efforts to address SDOH by introducing initiatives that specifically target these disparities.

Driving Action

Race and ethnicity, gender, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health. These determinants have a major impact on health outcomes, especially for our most vulnerable populations. To help practitioners take action to address SDOH, we offer the following:

  1. Empower people to make informed health decisions through advances in health literacy. Health literacy, defined as “the degree to which individuals have the ability to find, understand and use information and services to inform health-related decisions and actions for themselves and others”, plays a critical role. When people are empowered to make informed decisions about their wellbeing, they are invested to make the best decisions concerning their health.
  2. Address individual needs through appropriate screening and referrals services. This includes examining how government services and benefit programs intersect on a personal level. We must reimagine how citizen services such as healthcare, housing, education, and transportation can work together to improve people’s health, well-being, and quality of life. 
  3. Utilize digital innovations to modernize the delivery of government services. This includes maintaining a focus on improving the citizen experience (CX) and delivering more personal, individualized services.  As digital advancements change the ways people interact with the government, it is important that customer contact channels are integrated with seamless hand-offs between them.
  4. Forge cross-sector partnerships that address the health and social needs of patients. People and organizations at the local, state, territorial, tribal, and national levels must continue to pioneer new ways to create the conditions people need to live healthier lives.

It is only when "all people have the opportunity to attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance" (Centers for Disease Control and Prevention) will we be able to address to achieve the promise of health equity.

Read our other Social Determinants of Health (SDOH) related content here.