As defined by the World Health Organization (WHO), social determinants of health are the conditions in which people are born, grow, live, work and age, including the influences of health systems. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.
Social determinants of health can be divided into 12 categories that contribute to how healthy a person may or may not be.
1) Income and Social Status:
- Generally, people are healthier when they are wealthier. Individuals with lower socio-economic status experience worse health outcomes than individuals with higher socio-economic status.
- Income shapes living conditions, such as adequate housing and ability to buy sufficient quality food. When people have little control over their lives and few options, their bodies are more vulnerable to disease. Income also influences psychological functioning and health-related behaviours.
2) Education and literacy:
- Education is closely tied to income and socio-economic status. People with higher levels of education tend to use preventative medical services more frequently, be more physically active, and generally have better health.
- Low literacy has a negative effect on all aspects of health, including overall levels of life expectancy, accidents and chronic diseases such as diabetes, cardiovascular disease and cancer. Low literacy also has a negative impact on mental health and on the ability to prevent illness.
3) Employment/Working conditions:
- Employment allows people to afford basic necessities such as appropriate housing, food, and clothing—all of which are essential for good health. Employment also provides a sense of identity and purpose, social contacts and an opportunity for personal growth.
- Conditions at work can have a significant effect on people’s health and emotional well-being.
4) Social environments:
- Social environments include immediate physical surroundings, social relationships and cultural environments within which groups of people function and interact.
- Negative social environments and experiences of discrimination and homophobia is associated with high rates of suicide attempts by lesbian, gay and bisexual youth.
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Positive social environments include elements such as safety and social stability, recognition of diversity, good working relationships and cohesive communities, and help reduce or avoid many potential risks to good health.
5) Physical Environments:
- Exposure to contaminants in our air, water, food and soil can cause a variety of adverse health effects, including cancer, birth defects, respiratory illness and gastrointestinal ailments.
- Factors related to housing, indoor air quality and the design of communities and transportation systems can also significantly influence people’s physical and psychological well-being.
6) Personal health practices and coping skills:
- Personal health practices and coping skills refer to actions that individuals can take to prevent diseases and promote self-care, cope with challenges, develop self-reliance, solve problems, and make choices that enhance personal health.
- Making personal health choices about such things as smoking, alcohol consumption, high fat diets, and regular dental health care all influence personal health.
7) Healthy child development:
- The effects of early childhood experiences have strong immediate and longer-lasting biological, psychological and social effects upon health.
- The quality of early childhood development is largely influenced by the economic and social resources available to parents.
- Children living under conditions of material and social deprivation are at higher risk of health problems.
8) Biology and genetic endowment:
- In some circumstances, genetic and biological factors appears to predispose certain individuals to particular diseases or health problems.
- Examples of biological and genetic determinants of health include:
- age—older adults are more likely to be in poorer health than adolescents due to the effects of aging
- sex—women are at risk of pregnancy and birth-related health problems
- inherited conditions—examples of inherited disease include sickle-cell anemia, hemophilia and cystic fibrosis
- abnormal genes—carrying certain genes increases a person’s risk for breast and ovarian cancer
9) Health services:
- One of the most crucial determinants of health is access to high-quality health services.
- Men and women from higher income households who are more likely to have insurance are much more likely to self-report that they have visited a dentist within the past year than people with lower incomes.
- Populations who are underserved by health services include Aboriginal People, members of the LGBTTIQcommunity, refugees and other immigrants, ethnically or racially diverse populations, people with disabilities, the homeless, sex trade workers and people with low incomes.
10) Gender:
- Gender-based differences—in access to or control over resources, in power or decision making, and in roles and responsibilities—have implications for a person’s health status.
- Research shows that women live longer than men, on average. Women have higher death rates, but men are more prone to accidents and also more likely to be perpetrators and victims of assault, reducing their overall life expectancy.
11) Culture:
- Some individuals or groups may face additional health risks as a result of a socio-economic environment that is largely determined by dominant cultural values. These dominant values can contribute to conditions such as marginalization, stigmatization, the loss or devaluation of language and culture, and a lack of culturally appropriate health care and services.
- Members of racialized groups, recent immigrants and Aboriginal People are often among the most marginalized groups in society.
12) Social support networks:
- Evidence shows that support from families, friends and communities is a big contributor to better health.
- The caring and respect that occurs in social relationships, and the resulting sense of satisfaction and well-being, seem to act as a buffer against health problems.
- Racism is a prominent form of social exclusion. The experience of racial discrimination puts racialized groups at higher risk for physical and mental health concerns.
