3: Social Determinants of Health
- Page ID
- 116167
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Author's note: This chapter is a work-in-progress and has not yet been fully revised or updated, as of 2025. Also, part of the chapter refers to a video that is not OER -- the Unnatural Causes series -- that offers some clips for free, but the full videos are only available through libraries that have a license (try Kanopy at your local college or public library) or for a fee on Vimeo.
- 3.1: Learning Outcomes
- This page focuses on the second part of a lesson about the "Unnatural Causes" video, emphasizing how social determinants affect population health and health inequities. It explores data showing that inequality impacts health outcomes significantly and discusses various factors, including neighborhood and national influences. The lesson also highlights that social determinants are changeable, offering evidence that improving these factors can enhance health outcomes.
- 3.2: What are "social determinants of health?"
- This page discusses the determinants of health, which include biological, behavioral, and social factors. Biological determinants are genetic, while behavioral ones are influenced by social conditions. Social determinants involve societal and economic factors impacting health outcomes. Public health examines population trends, showcasing that wealthier individuals typically have better health and longevity.
- 3.3: Healthy People 2030 and the Social Determinants of Health
- This page outlines the Healthy People 2030 (HP 2030) initiative, which sets national health goals in the U.S. every decade. HP 2030 focuses on promoting well-being, reducing health disparities, and fostering healthy development throughout life stages, addressing social determinants of health since 2010. It specifies objectives and interventions to improve health and emphasizes the importance of supportive health policies.
- 3.4: Ecological Model and the Social Determinants
- This page explores the relationship between ecology and health, highlighting how social determinants and environmental factors influence individual well-being. It stresses the importance of recognizing that health risks often arise from community-level issues rather than solely personal actions or genetics. The ecological model advocates for collective action to drive social change, suggesting that individuals can positively impact their communities for better health outcomes.
- 3.5: UNNATURAL CAUSES- In Sickness and In Wealth
- This page reviews the first episode of "Unnatural Causes: Is Inequality Making Us Sick?", which examines financial social determinants of health like social class and income, and references "The Raising of America" on early childhood factors. Students are urged to take notes and contemplate critical questions about the material. Although produced in 2008, the video remains a valuable resource for grasping key concepts regarding social determinants of health.
- 3.6: Social determinants have a major impact on health.
- This page highlights how social status profoundly impacts health outcomes, often surpassing diet or exercise. It presents both quantitative data showing correlations between socioeconomic status and health conditions, and qualitative data through personal stories that illustrate these themes. The Covid-19 pandemic reinforced these links, revealing disparities in exposure and illness severity.
- 3.7: Embodiment
- This page discusses health disparities, highlighting Nancy Krieger's "embodiment" concept, which connects social inequities to biological health. It emphasizes how chronic stress from factors like job control and living conditions affects health via cortisol's impact on the cardiovascular and immune systems. The persistent stress contributes to health inequities, underscoring the need to explore societal roots of these stressors and effective community coping strategies.
- 3.8: Inequality Itself Correlates to Worse Health
- This page discusses how inequality affects health across all social strata, emphasizing research by Richard Wilkinson that indicates health outcomes in developed nations are more related to inequality than to wealth levels beyond basic needs. It highlights the role of stress responses linked to social status and the impact of individuals' perceptions of their social standing on health disparities.
- 3.9: Inequality in the United States
- This page discusses a study that reveals a correlation between income inequality and shorter life spans in the U.S. conducted by the University of Wisconsin and the Robert Wood Johnson Foundation. It suggests that people in unequal communities are likelier to die before age 75, with theories proposed about how inequality affects health.
- 3.10: Making Change
- This page highlights the importance of social determinants of health and the potential for positive change. It underscores that these determinants can be altered by society, referencing historical improvements in health equity. Economic policies significantly impact health outcomes, and recent initiatives by public health departments and community organizations strive to tackle health inequalities. The core message conveys that progress is achievable through targeted policy changes.
- 3.11: Actions that work toward equality and health
- This page discusses efforts to address health inequities in Louisville through resident engagement and the importance of social determinants highlighted in a Northern California report. It emphasizes community capacity building, partnerships, and initiatives such as health assessments, environmental improvements, and living wage campaigns.
- 3.12: Making Changes to the Social Determinants Benefits Health
- This page highlights the critical role of social determinants of health, like racism and isolation, in affecting community health and health inequities. It acknowledges the difficulties of overcoming oppression but suggests that meaningful progress can be achieved through effective public policy initiatives, such as the Affordable Care Act and federal programs like student loan forgiveness and the child tax credit.
- 3.13: Change Can Happen
- This page highlights the influence of social determinants of health and effective policies in addressing poverty and income inequality, focusing on the Stockton, California guaranteed basic income experiment and the 2021 Child Tax Credit expansion. Both initiatives are linked to better health and employment outcomes. The author argues that equitable policies can enhance life expectancy and overall quality of life, underscoring their potential to reduce disparities.
- 3.14: Supplemental Reading on Social Determinants Affecting Health Outcomes
- The section explores health equity and disparities, highlighting that social determinants of health significantly impact health outcomes more than clinical care. It emphasizes that achieving health equity requires distributing resources based on individual needs rather than equally. It covers topics like economic stability, neighborhood environments, education, social context, and how inequalities cumulatively affect health.