IT IS TIME TO REFOCUS, REINFORCE, AND REPEAT THE MESSAGE THAT HEALTH DISPARITIES EXIST AND THAT HEALTH EQUITY BENEFITS EVERYONE.
KATHLEEN G. SEBELIUS
WHAT ARE SOCIAL DETERMINANTS OF HEALTH (SDoH)?
As defined by the World Health Organization Social Determinants of Health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities — the unfair and avoidable differences in health status seen within and between countries.
Simply put, social determinants of health are all of the conditions of an individual’s surroundings that affect their general health.
WHAT CONDITIONS IMPACT OUR HEALTH?
WHAT ARE THE EFFECTS OF SDOHs?
Life expectancy of Americans increased from 69.7 years in 1950 to 78.8 years in 2015. However, despite the overall improvement, substantial gender and racial/ethnic disparities remained. In 2015, life expectancy was highest for Asian/Pacific Islanders (87.7 years) and lowest for African-Americans (75.7 years). Life expectancy was lower in rural areas and varied from 74.5 years for men in rural areas to 82.4 years for women in large metro areas, with rural-urban disparities increasing during the 1990-2014 time period. Infant mortality rates declined dramatically during the past eight decades. However, racial disparities widened over time; in 2015, black infants had 2.3 times higher mortality than white infants (11.4 vs. 4.9 per 1,000 live births). Infant and child mortality was markedly higher in rural areas and poor communities. Black infants and children in poor, rural communities had nearly three times higher mortality rate compared to those in affluent, rural areas. Racial/ethnic, socioeconomic, and geographic disparities were particularly marked in mortality and/or morbidity from cardiovascular disease, cancer, diabetes, COPD, HIV/AIDS, homicide, psychological distress, hypertension, smoking, obesity, and access to quality health care.
Despite the overall health improvement, significant social disparities remain in a number of health indicators, most notably in life expectancy and infant mortality. Marked disparities in various health outcomes indicate the underlying significance of social determinants in disease prevention and health promotion and necessitate systematic and continued monitoring of health inequalities according to social factors. A multi-sectoral approach is needed to tackle persistent and widening health inequalities among Americans.
Singh GK, Daus GP, Allender M, et al. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016. Int J MCH AIDS. 2017;6(2):139-164. doi:10.21106/ijma.236
The Center's mission is to advance evidence-based, individualized behavioral interventions to overcome health disparities associated with social determinants of health. Our overarching goal is to design and implement highly effective, culturally appropriate intervention approaches.