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Social Determinants of Health

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What are the Social Determinants of Health?

The places where people live, learn, work, and play shapes health in many ways. Some neighborhoods have plenty of places to get affordable, nutritious food while others don’t have access to a supply of fresh produce. Place affects diet, which affects health. Other aspects of the places where people live matter, too. The availability of good homes and jobs nearby can create stronger communities, which benefits mental health. On the other hand, the  arrangement of buildings and roads can leave people feeling stressed and isolated – and even lead to higher levels of pollution. Housing, economic and social policies are also health policies.

The social determinants of health are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. According to the national Healthy People 2030 initiative, social determinants of health include economic stability, education access and quality, health care access and quality, neighborhood and built environment, social and community context. Some estimate that nearly 80% of health outcomes are driven by social determinants as opposed to clinical care.

The Healthy People 2030 goals for addressing social determinants to health into the following categories. 

  • Economic stability. Goal:  Increase opportunities for people earn steady incomes that allow them to meet their health needs.
  • Education access and quality. Goal: Increase educational opportunities and help children and adolescents do well in school.
  • Healthcare and access quality. Goal: Increase access to comprehensive, high-quality health care services.
  • Neighborhood and built environment. Goal: Create neighborhoods and environments that promote health and safety.
  • Social and community context. Increase social and community support.

Addressing social determinants also strengthens community and individual resilience to disasters such as the COVID-19 pandemic. Related to social determinants of health is social vulnerability, which refers to the negative effect on communities due to external stressors on human health. Reducing social vulnerability can decrease both human suffering and economic loss1.

Why Place Matters

Life expectancy can be predicted by ZIP Code based on an analysis of a range of factors including social determinants of health. Often social determinants of poor health and threats to resilience coexist in communities. For example, the same communities that experience food deserts or lack access to healthy food are also likely to face other barriers, such as large numbers of single-parent households, lack of access to high-performing schools, and lack of access to safe and affordable housing. This correlation was most recently demonstrated in the COVID-19 pandemic, which had its earliest and most severe impacts on communities who experience many social determinants of poor health. 

Emergency response experts agree that reducing a community’s social vulnerability can decrease both human suffering and economic loss in a disaster2.  Recently, many data tools have been developed to quantify community-level barriers to health. Indices considering social determinants of health have emerged as critical tools for emergency response efforts to target “vulnerable” communities, as well as for long term planning to address systemic inequities. Using CDC data, Ohio has designated 735 neighborhoods as Ohio Health Improvement Zones. The Health Improvement Zones are in urban and rural communities located across the state that face multiple high-risk factors which makes them vulnerable to disaster, such as a pandemic. The Health Improvement Zones are central to Ohio’s equitable response to COVID-19 and to the Ohio Department’s health equity strategies3

Key Initiatives To Address A Social Determinants Of Health

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