1. Introduction
Healthcare disparities do not exist in isolation—they are deeply influenced by broader social, economic, and environmental factors that affect people’s health and well-being. These factors are known as Social Determinants of Health (SDOH).
What are Social Determinants of Health (SDOH)?
The World Health Organization (WHO) defines SDOH as:
“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.”
These determinants directly impact health outcomes, influencing who gets sick, who receives care, and who has access to a healthy lifestyle. Addressing SDOH is crucial for reducing health disparities and improving health equity worldwide.
Key Learning Objectives
By the end of this lecture, you will understand:
✅ The five key domains of Social Determinants of Health.
✅ How SDOH affect health outcomes across different communities.
✅ Real-world examples of health disparities linked to SDOH.
✅ Strategies for improving health equity through policy and intervention.
2. The Five Key Domains of Social Determinants of Health
The U.S. Centers for Disease Control and Prevention (CDC) and WHO classify SDOH into five main categories:
A. Economic Stability – How financial security influences health
Economic stability refers to an individual’s ability to afford basic necessities like food, housing, and healthcare. Financial insecurity is one of the biggest contributors to poor health.
- Common Issues:
- Low income and unemployment.
- Food insecurity (lack of access to nutritious food).
- High healthcare costs leading to delayed medical care.
- Poor housing conditions due to financial strain.
Example:
In the U.S., low-income individuals are twice as likely to develop chronic illnesses like diabetes and heart disease due to limited access to preventive care and nutritious food.
B. Education Access and Quality – The role of education in health outcomes
Higher education is linked to better health outcomes, longer life expectancy, and improved access to healthcare services. People with limited education often experience worse health outcomes due to lower health literacy.
- Common Issues:
- Low literacy rates affecting health awareness.
- Limited access to quality primary and higher education.
- Lack of knowledge about healthy behaviors and preventive care.
- Poor employment opportunities due to lack of education.
Example:
Studies show that adults with lower education levels have higher rates of smoking, obesity, and mental health issues compared to those with college degrees.
C. Healthcare Access and Quality – Barriers to medical care
Access to affordable, high-quality healthcare is a major determinant of overall well-being. Many individuals face barriers to medical services, leading to higher rates of untreated diseases and preventable deaths.
- Common Issues:
- Lack of health insurance.
- Shortage of healthcare providers, especially in rural areas.
- High costs of medications and medical procedures.
- Implicit bias and discrimination in healthcare.
Example:
In many low-income countries, women are less likely to receive prenatal care, leading to high maternal and infant mortality rates.
D. Neighborhood and Built Environment – How surroundings affect health
Where people live impacts their exposure to pollution, access to healthcare facilities, and lifestyle choices. Safe environments promote better health, while poor living conditions increase disease risks.
- Common Issues:
- High crime rates leading to stress and mental health problems.
- Lack of clean water and proper sanitation.
- Exposure to environmental hazards like air pollution and lead poisoning.
- Inadequate transportation, making it difficult to access healthcare.
Example:
Residents in urban areas with high air pollution levels are at a greater risk of asthma, lung cancer, and cardiovascular diseases.
E. Social and Community Context – The impact of relationships and support networks
A strong support system improves health outcomes, while social isolation and discrimination contribute to stress, depression, and poor overall well-being.
- Common Issues:
- Social isolation, particularly among the elderly.
- Racism, discrimination, and stigma in healthcare settings.
- Family instability and exposure to domestic violence.
- Workplace discrimination affecting economic stability.
Example:
LGBTQ+ individuals often face higher rates of mental health issues due to discrimination and lack of supportive healthcare providers.
3. How SDOH Impact Health Disparities
A. SDOH and Chronic Diseases
- Low-income communities experience higher obesity rates due to limited access to fresh food.
- Individuals with lower education levels are more likely to smoke, increasing cancer risks.
- Air pollution in low-income urban areas increases asthma cases among children.
B. SDOH and Mental Health
- Job instability and financial stress contribute to higher rates of anxiety and depression.
- Social isolation, especially among elderly populations, leads to increased suicide risks.
- Discrimination and stigma prevent marginalized groups from seeking mental health care.
C. SDOH and Infectious Diseases
- Poor housing and lack of clean water increase the spread of diseases like tuberculosis and cholera.
- Limited healthcare access in rural areas leads to higher HIV transmission rates.
- Refugees and displaced populations face higher risks of infectious disease outbreaks due to overcrowding.
4. Strategies to Improve Social Determinants of Health
✅ Universal healthcare policies to improve access for underserved populations.
✅ Job training and financial aid programs to enhance economic stability.
✅ Investment in quality education to improve health literacy.
✅ Affordable housing programs to reduce homelessness and improve living conditions.
✅ Stronger anti-discrimination policies to promote fair treatment in healthcare.
5. End of Lecture Quiz
1. Which of the following is a Social Determinant of Health?
A) Genetics
B) Education level (Correct Answer: B – Education influences health literacy and employment opportunities.)
C) Personality
D) None of the above
2. Why do low-income communities experience higher rates of chronic diseases?
A) They have limited access to healthy food and preventive care (Correct Answer: A – Economic instability affects nutrition and healthcare access.)
B) They choose to be unhealthy
C) They live in rural areas
D) They have better access to doctors
3. What is a key solution to improving health disparities?
A) Increasing healthcare costs
B) Ignoring racial and economic inequalities
C) Expanding access to healthcare and education (Correct Answer: C – Addressing SDOH leads to better health equity.)
D) Removing free health services
6. Additional Resources for Further Learning
-
World Health Organization (WHO) – Social Determinants of Health:
https://www.who.int/social_determinants/en/ -
Centers for Disease Control and Prevention (CDC) – Social Determinants of Health:
https://www.cdc.gov/socialdeterminants/index.htm -
Robert Wood Johnson Foundation – Health Equity & SDOH Research:
https://www.rwjf.org/en/library/research/2021/03/social-determinants-of-health.html
7. End of Lecture Summary – Key Takeaways
✅ Social Determinants of Health (SDOH) are critical in shaping health outcomes.
✅ Low-income, minority, and rural populations face the greatest health disparities due to SDOH.
✅ Addressing SDOH through policies and community programs is key to achieving health equity.
By understanding and addressing social determinants of health, we can create a healthier, fairer world for all.
