Social Determinants of Health

Social determinants of health (SDOH) are described by the World Health Organization as the non-medical factors and forces of someone’s daily life that impact their health outcomes. Where someone was born—and where they live, work, play, and worship—all contribute to their health risks and outcomes. SDOH recognize that individual and population health, as well as health inequities, are influenced by one’s physical environment, socioeconomic factors, access to and quality of health care available, and personal health.

Healthy People 2030 Social Determinants of Health graphic

Citation: Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved September 1, 2022, from https://health.gov/healthypeople/objectives-and-data/social-determinants-health

The U.S. Department of Health and Human Services's Healthy People 2030 project groups SDOH into five domains:

1. Economic Stability

Opportunities for steady employment
Affordability of food, housing, health care, and education

2. Education Access and Quality

Access to high-performing schools
Barriers to participation in school
Access to postsecondary education such as trade schools or colleges

3. Health Care Access and Quality

Access to insurance
Access to a primary care provider
Access to preventive care
Proximity to qualified providers, pharmacies, and medical supply stores

4. Neighborhood and Built Environment

Rates of violence and exposure to crime
Safety of air quality and water levels
Exposure to hazards such as noise and secondhand smoke
Access to healthy food and opportunities to exercise

5. Social and Community Context

Social supports within the community
Civic participation
Discrimination
Workplace conditions
Rates of incarceration

Cultural responsiveness includes understanding and appropriately including and responding to the combination of cultural variables an individual brings to interactions. A person’s SDOH may shape their views toward health and health care and may influence access to services and supports. These are important considerations as clinicians plan evaluation, treatment, and discharge activities and recommendations. By identifying and addressing someone’s SDOH along with their functional status and personal goals, clinicians can create achievable, sustainable plans. Screening for SDOH—and combining the results with community-based resources—is an important action step for providers and interprofessional teams.

SDOH may be captured through the International Classification of Functioning, Disability, and Health (ICF) framework. The ICF’s Contextual Factors include environmental factors that are not within a person’s control. The other part of the ICF—Functioning and Disability factors—includes Activity and Participation considerations that describe how someone interacts with their environment.

For additional information on SDOH, see the tools and resources below.