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The Social Determinants of HealthThe social determinants of health (SDOH) are key social factors that affect our health.Much of the profound inequity in health outcomes, both within and between countries, is socially mediated and determined. This inequality arises from peoples' social conditions and experiences - where they live and work, social relations, institutional settings, early life experiences, educational opportunities, privilege, wealth and status, etc. These social factors, or social determinants of health, are responsible for the majority of the global burden of disease and of health inequalities within and between countries. Studies from the 1980's demonstrated that health improves across all socio-economic status ranges regardless of where along the spectrum an individual resides. In other words, the wealthier you are, the better health you have compared to anyone lower on the socio-economic ladder. At the same time, there remains a correlation between social class and infant mortality rates, and life expectancy and inequalities in the use of medical services. In other words, poorer health experience of lower occupational groups applied at all stages of life. In effect, what is observed is that individuals at the bottom of the hierarchy have a higher risk of heart attacks - the lower you were in the hierarchy, the higher the risk. More astonishingly, the same applied to all the major causes of death - cardiovascular disease, gastrointestinal disease, renal disease, stroke, accidental violent deaths, cancers that were not related to smoking as well as cancers that were related to smoking. One might believe that more high pressure jobs with higher incomes and responsibilities would cause greater stress and poorer health. What these studies found across countries and between countries, was quite the opposite. "Sir Michael Marmot says that our health and longevity is influenced to a high degree by our social standing. Status it seems, is more important than genetics, or even smoking - and yeah, even money. Your position in the hierarchy very much relates to how much control you have over your life and your opportunities for full social engagement." As a relative issue, SDOH underscore the importance of relative socio-economic status and capabilities within a particular social setting. Now the irony - capitalism is structured inequality. Hunter-gatherers on the other hand (along with many of their descendants we see in Aboriginal populations today in their traditional forms), tirelessly sought to ensure egalitarianism, even when those actions would lead to less optimal outcomes for the individual. |
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| Sustainability Coaching | Determinants of Health |
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| Energy | WHO Commission on the Social Determinants of Health | |
| Housing | ||
| Climate Change | Senate Subcommittee on Population Health SDOH Meetings | |
| Transportation and mobility | SDOH Listserv at York University | |
| Urban Planning and Access | Dennis Raphael's Website | |
| Behaviour and Lifestyle Change | ||
| Health Promotion | ||
| Social Health Determinants | ||