What are Social Determinants of Health?

I promise to be brief, for it is normally a very long-winded explanation.

There is a whole vast, complex, and entirely organic system of factors that dictate the health of a person on a daily basis. While many of these factors happen in a completely unpredictable manner based purely on chance, a large portion of these are much more consistent. A few of the more important ones to note are of the social sort: Race, social class, language, education, gender, family status, and age. Chief among these is race... Race has a tremendous impact on the health of a person because it can very often dictate what neighborhood a person may live in, the jobs they can receive, the resistance they experience when climbing society's ladder, etc.. The Neighborhood they live in can dictate what sort of environmental risks they are exposed to, the foods options available, air quality, quality of public infrastructure, and so forth. Social determinants are an integral part of a person's life trajectory and are completely unavoidable.

One of the more tantamount things to note is that determinants such as income simply bear very little weight until you place them into society's spectrum, as so eloquently stated in the Whitehall study of 1967-77. This study revealed that among a large sample of already well-off British civil servants, there was a striking discrepancy between the health of the highest paid and ranked individuals to that of the lowest paid and ranked individuals. Part of this can be attributed to the pressures the people lower on the gradient feel to 'climb the ladder' and the chronic stress that is associated with that. Someone at the forefront of bringing this knowledge to the public is Richard Wilkinson, who provides compelling data about income inequality and the disastrous health consequences it has on a national level (video below). He states ‘The larger the disparity between rich and poor, the poorer the health of the nation.' I wholeheartedly agree, as it perpetuates a steeper social gradient.

One tool I would recommend you use to analyze social determinants of health in your own community is this, the Built Environment Atlas of Multnomah County. It breaks the county up into districts and draws correlations between living standards, exposure to wildlife, available food options, and more with the average income, race, and education levels of members of the district. It is very interesting because it provides a visual representation of the inequality on an eerily close to home level. The link is found below.

Multnomah County Built Environment Atlas

Given this knowledge, I would invite you evaluate what sort of social determinants contribute to your health, and which ones may be of detriment. It can be something as tantamount as Race or Gender, or as minuscule as what sort of transportation you use or the whiteness of your teeth. After you are done evaluating this, please tell me why you think they have the impact they do, whether the impacts are good or bad!