Social Determinants of Health.
According to the Centers for Disease Control and Prevention (CDC), as adapted from the World Health Organization (WHO), Social Determinants of Health (SDOH) are “the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, worship, and age. These conditions include a wide set of forces and systems that shape daily life such as economic policies and systems, development agendas, social norms, social policies, and political systems. Addressing differences in SDOH accelerates progress toward health equity, a state in which every person has the opportunity to attain their highest level of health. SDOH have been shown to have a greater influence on health than either genetic factors or access to healthcare services.”
SDOH are the conditions in the environments where 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. They can be grouped into 5 domains:
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- Economic Stability: Addresses the need for people to earn steady incomes that allow them to meet their health needs. Factors related to this group include employment status, income level, poverty level, housing affordability, food insecurity, and access to financial resources.
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- Education Access and Quality: Addresses the need for people to have access to educational opportunities and help children and adolescents do well in school. Factors related to this group include educational attainment (e.g. high school, college), literacy levels, enrollment in early childhood education, access to quality primary and secondary schools, access to higher education and vocational training.
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- Healthcare Access and Quality: Addresses the need for people to have access to comprehensive, high-quality health care services. Factors related to this group include health insurance coverage, availability of primary care providers, access to culturally and linguistically appropriate care, quality of health services, and barriers to accessing care (e.g. cost, transportation).
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- Neighborhood and Built Environment: Addresses the need for people to live in neighborhoods and environments that promote health and safety. Factors related to this group include housing quality and stability, access to nutritious and affordable food, neighborhood safety and violence exposure, environmental conditions (e.g. air and water quality), availability of public transportation, and access to recreational facilities.
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- Social and Community Context: Addresses the need for people to have social and community support through positive relationships and interactions with family, friends, co-workers, and community members. Factors related to this group include social support networks, civic participation (e.g. voting, community engagement), discrimination and social exclusion, workplace conditions (e.g. stress, discrimination), and family structure and dynamics.
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CDC PLACES is a collaboration between CDC, the Robert Wood Johnson Foundation, and the CDC Foundation. PLACES provides model-based estimates of 40 chronic disease and other health related measures and 9 social determinants of health measures from the American Community Survey (ACS) at county, place, census tract, and ZCTA levels.
HOI Methodology HOI Indicators Explore the HOI Visit CDC PLACES