Social determinants of health (SDOH) are the social and economic factors that influence people’s health status. The number of SDOH’s vary depending on the list you are looking at, but all are things that can positively or negatively affect one’s health and health outcomes.
For the purpose of this blogpost I will use the list of 17 SDOH that was developed in 2002 at York University.
These are:
• Disability
• Early child development
• Education
• Employment and working conditions
• Food insecurity
• Gender
• Geography
• Globalization
• Health services
• Housing
• Immigration
• Income and income distribution
• Indigenous ancestry
• Race
• Social exclusion
• Social safety net
• Unemployment and job security
All of these things can and do contribute to health outcomes, either in a positive or negative manner and the effects of these things on health are actually more impactful than many personal health decisions. The stress associated with precarious housing or employment or being unable to make ends meet can add physical and emotional strain which can impact ones’ health. Furthermore, if a person is struggling with many difficult life situations, they are often not able to engage in positive health activities such as social engagement and physical activity which can further widen the disparity.
Some SDOH are modifiable and others are not, but I would suggest that even non-modifiable SDOH should be considered when making political decisions to ensure that these decisions do not increase the health equity gap. I would be remiss to speak about the SDOH and not speak about social injustice. Canada, like many other countries is a place where those who are the most impoverished have reduced life expectancy, lower health status and poorer health outcomes. Canada has not done enough to mitigate this – we tout ourselves on being a country with universal health care and one of the best places to live in the world but do too little to address the social conditions that are contributing to Canadians getting sick in the first place. In essence, we are plucking people out of the river only to move them back upstream a few feet and drop them back in. More needs to be done to ensure that all Canadians have access to safe drinking water, healthy housing that does not make them sick, adequate resources to be able to make ends meet and social connectedness within the places that they live.