Social determinants of health

Reasons why we should concern ourselves with addressing the social determinants of health.

Michigan State University Extension has a wealth of resources to help people learn about being healthy. So, what contributes to being healthy? It is more complex than you may think. We all get messages from our doctors, and sometimes the media, that say in order to be healthy we should eat right, get a lot of physical activity, drink water, don’t smoke, get enough sleep and see your doctor regularly. All of these are good and proven strategies and mostly in our power. However, in a report released in 2010 called Healthy People 2020, a more in-depth description of what actually makes people or populations healthy is summarized as the social determinants of health.

As explained in Healthy People 2020, “Social determinants of health are conditions in the environment in which 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.”

In essence, social determinants of health include the things mostly within our power, as talked about in the previous paragraph, along with social and economic opportunities, our home environment, neighborhood and community, quality of education and schools, safe work environments, access to clean air, food and water and even our relationships and interactions with others in society.

The resources and supports in our environments largely determine how healthy or unhealthy we are. For example, according to the CDC, if you live in poverty you are more likely to have less access to healthy foods, clean water and live in unsafe neighborhoods with substandard education. When looked at through the lens of where we live, we have a better understanding of why some people are healthy and some are not as healthy as they could be.

By addressing issues of social determinants of health on multiple levels with multiple agencies, community partners and policy makers, more people have an equal opportunity to make choices that help them be healthy. It is more than just advancing health care. It is also looking for ways to improve things such as affordable housing, quality education in all neighborhoods, reliable and safe public transportation, safe neighborhoods and working to plan walkable/accessible communities with access to a bounty of healthy food choices.

Healthy People 2020 has grouped the social determinants of health into five key areas. Within each of these areas are underlying factors. For each of these they have developed objectives, tools and strategies.

  • Economic stability
    • Poverty, employment, food insecurity, housing insecurity
  • Education
    • High school graduation, enrollment in higher education, language and literacy, early childhood education and development
  • Social and community context
    • Social cohesion, civic participation, discrimination, incarceration
  • Health and health care
    • Access to health care, access to primary care, health literacy
  • Neighborhood and build environment
    • Access to foods that support health eating patterns, quality of housing, crime and violence, environmental conditions

Why should we concern ourselves with addressing the social determinants of health? One reason is that the health of our population affects our nation’s prosperity and security. According to the Healthy People 2020 Secretary’s Advisory Committee, “A recent study found that labor time lost in the United States due to health reasons costs $260 billion per year. The National School Lunch Program was originally established because, during World War II, nearly 40 percent of potential recruits were too undernourished to be eligible for the military. Now, three out of four young adults between the ages of 17 and 24 are ineligible for military service, often due to obesity. Nearly 21 percent of military recruits were rejected in 2008 because they were overweight.”

What can you do? You can start by getting involved in your community. Talk to people you know and agencies in your area such as your county MSU Extension office, neighborhood association, place of worship, local health department, hospitals, clinics, health care providers, city planning commission and schools. Begin conversations on social determinants of health and find out who is already doing work on this effort and then get involved. You may be the spark that helps make your community healthier. 

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