What are the Social Determinants of Health?
The social determinants of health (SDH) refer to the non-medical factors that influence health outcomes. These determinants encompass a wide range of conditions in which individuals are born, grow, live, work, and age, as well as the broader societal forces that shape these conditions.
These key aspects of social determinants include:
economic stability,
education access and quality,
healthcare access and quality,
neighbourhood and built environment, and
social and community context.[1,2]
It explains how your life circumstances can shape your health, even before you step into a doctor's office.
Think of your health like a house. While doctors and medicines are important, just like repairs and maintenance, the foundation of your health is built by your daily life experiences. These experiences start from the day you're born and continue throughout your life.
Let’s take an example.
Imagine two people: Sarah and Mike.
Sarah has a steady job that pays well, allowing her to buy fresh food and live in a safe neighbourhood with parks nearby. She has time for regular check-ups and can afford them. When she's stressed, she has friends and family to talk to.
Mike, however, works two jobs to make ends meet. He often skips doctor visits because he can't afford to take time off. His neighbourhood has few grocery stores, mainly fast-food restaurants. He's often too tired to exercise, and stress from financial worries keeps him up at night.
These different life situations – having enough money, a good education, access to doctors, a safe place to live, and supportive relationships – affect their health just as much as, if not more than, their genes or medical care.
When someone gets sick, we often focus on their symptoms or treatment. But preventing illness often means looking at these bigger pieces of life's puzzle:
Can they afford healthy food?
Do they have time to exercise?
Can they see a doctor when needed?
Do they have people to lean on during tough times?
Understanding these connections helps us see why improving community resources, education, and economic opportunities isn't just about social progress – it's about creating a healthier society for everyone.
Let's continue our story about health and society, because there's something important, we need to understand about fairness.
The stories of Sarah and Mike help us understand a bigger truth: health differences between people often aren't just about personal choices or bad luck. Instead, they're like a domino effect that starts with how society is organized.
Think about it this way: If you live in a neighbourhood where fresh food is scarce, gyms are expensive, and the air is polluted from nearby factories, staying healthy becomes like trying to swim upstream. Scientists have discovered that these life circumstances influence our health more than whether we can see a doctor or not – they're responsible for about one-third to half of our health outcomes.
Link to climate change
Climate change consequences are neither gender nor diversity neutral - UN
The SDH explains why the consequences of climate change reinforce systemic inequalities.
Let's go back to Sarak and Mike stories.
Their different life situations show us something crucial about climate change too. When extreme weather events strike, their impacts aren't felt equally – they're like adding weight to an already unbalanced scale.
Think about a heat wave hitting their neighborhoods. Sarah lives in an area with plenty of trees for shade, her home has good air conditioning, and she can work from home on extremely hot days.
But Mike's situation is different. His neighborhood has few trees, making it much hotter than other parts of town (this is called a "heat island"). His apartment lacks proper cooling, and his jobs require him to work outside. When the temperature soars, he faces a tough choice between losing essential income or risking his health.
The same pattern appears with other climate impacts. When floods occur, people with fewer resources often live in more vulnerable areas and struggle to recover from damage to their homes. During droughts, rising food prices hit hardest those who are already stretching their budgets. Poor air quality from wildfires affects everyone, but it's especially dangerous for those who can't afford air purifiers or live in areas with more pollution.
It's like a domino effect:
Climate change takes existing inequalities in housing, income, healthcare access, and job flexibility, and amplifies them.
Those with fewer resources not only face greater exposure to climate risks but also have less ability to protect themselves or recover from disasters.
This understanding helps us see why addressing climate change isn't just about protecting the environment – it's about creating a fairer society where everyone has the resources and support they need to stay healthy and resilient in a changing world.
Just as health isn't just about medicine, protecting people from climate impacts isn't just about reducing emissions – it's about ensuring everyone has the means to adapt and thrive.
Addressing Social Determinants
The good news is that we can change this story.
Just like we can improve a garden by adjusting its environment, we can make our communities healthier places for everyone.
This means thinking beyond just building more hospitals or hiring more doctors.
It means creating good schools, ensuring everyone has access to healthy food, making neighborhoods safer, and creating job opportunities that provide stable incomes.
When we work together to make these changes, we're not just helping individuals – we're building a fairer world where everyone has a better chance at good health.
After all, shouldn't everyone have a fair shot at living a healthy life, regardless of where they were born or how much money they have?
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