Objective Status

  • 6 Baseline only
  • 0 Developmental
  • 1 Research

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About the Workgroup

Approach and Rationale

The social determinants of health are the conditions and environments in which people are born, live, learn, work, play, worship, and age. SDOH affect a wide range of health, functioning, and quality-of-life outcomes and risks.1 SDOH represent nonmedical factors — like housing, transportation, and poverty — that affect health. Differences in these conditions may put people at risk for poor health outcomes.2,3 The concept of “place” is used to help understand how these determinants impact health. The social, economic, and physical conditions in different places not only impact health status, risks, health behaviors, and opportunities — they also affect the patterns of social interaction and overall well-being.4

The SDOH objectives are organized into 5 place-based domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.5 SDOH content is also interwoven throughout other Healthy People 2030 topics. SDOH objectives highlight the importance of upstream factors, typically outside of health care delivery, that are necessary to reduce health disparities and maintain healthy communities and populations. SDOH objectives are aligned with several federal strategies and priorities to improve value-based health care delivery and health outcomes.

Understanding Social Determinants of Health

Healthy People 2020 first introduced SDOH objectives in 2010.6 This emphasis on SDOH is shared by the World Health Organization (WHO).7 Social conditions and environments are shaped by a wider set of forces, including economics and social policies. 

Addressing SDOH means focusing on resources needed to maintain health and quality of life. Examples of those resources include safe and affordable housing, high-quality education, healthy foods, local health and emergency services, and environments free of life-threatening toxins with opportunities for safe physical activity. Understanding and addressing place-based determinants that are linked to health disparities can improve health and advance health equity.8,9

Citations

1.

World Health Organization. (2008). Commission on Social Determinants of Health – Final Report. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/43943/9789241563703_eng.pdf;jsessionid=D2EB5F0D0BC71039E0E64D1450E8E5AD?sequence=1

2.

Gornick, M.E. (March 2002). Disparities in Health Care: Methods for Studying the Effects of Race, Ethnicity, and SES on Access, Use, and Quality of Health Care.

3.

World Health Organization. (2010). A Conceptual Framework for Action on the Social Determinants of Health [PDF file]. Retrieved from https://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf

4.

Frumkin H. (2003). Healthy places: exploring the evidence. American Journal of Public Health, 93(9), 1451–1456. DOI: 10.2105/ajph.93.9.1451

5.

Office of Disease Prevention and Health Promotion. Explore Resources Related to the Social Determinants of Health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources

6.

Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020. (July 2010). Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the United States. Retrieved from https://www.healthypeople.gov/sites/default/files/SocietalDeterminantsHealth.pdf

7.

World Health Organization. (2008). Commission on Social Determinants of Health – Final Report. Retrieved from https://www.who.int/social_determinants/en

8.

Palmer, R.C., Ismond, D., Rodriguez, E.J., & Kaufman, J.S. (January 2019). Social Determinants of Health: Future Directions for Health Disparities Research. American Journal of Public Health, 109, S-70-S71. DOI: 10.2105/AJPH.2019.304964

9.

NEJM Catalyst. (Dec. 2017). Social Determinants of Health (SDOH). Retrieved from https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0312