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Why social determinants of health matter

GLENN ELLIS | 6/11/2018, 8:26 p.m.
Social Determinants of Health are the areas of your social and environmental condition and experiences that directly impact your health ...
Stock photo Associated Press

Strategies for Well-Being

Social Determinants of Health are the areas of your social and environmental condition and experiences that directly impact your health and health status.

Ask any care coordinator and you will hear story after story of patients whose clinical status was affected by challenges, such as access to care, socioeconomic or educational status, cultural norms and beliefs, and even their own living environments. Traditionally, these challenges are more familiar to those in public health fields rather than those with more clinical or health care administrative backgrounds. However, it is critical to have a deep understanding of the social determinants of health and how they affect every aspect of your health.

Health starts in our homes, schools, workplaces, neighborhoods and communities. We know that taking care of ourselves by eating well and staying active, not smoking, getting the recommended immunizations and screening tests, and seeing a doctor when we are sick all influence our health. Our health is also determined in part by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food and air; and the nature of our social interactions and relationships. The conditions in which we live explain in part why some Americans are healthier than others and why Americans more generally are not as healthy as they could be.

Many studies have shown a direct correlation between where a child lives and his or her future economic opportunities as an adult. A person’s health is determined by more than just access to health care. Social and behavioral factors contribute more than 60 percent of an individual’s health status. Research shows that health behaviors such as smoking, and diet and exercise are most determinants of premature death. Whether someone is able to engage in healthy behaviors is largely determined by a range of social, economic and environmental factors.

Research shows that health disparities are the greatest in poor neighborhoods populated with people of color. These groups have the highest levels of chronic disease and many other conditions.

Keep in mind that this phenomenon happens, particularly, in major cities where some of the world’s top medical and research institutions reside. Yet, one segment of the population enjoys healthy existences, while others, in the same city languish in sickness with poor health outcomes. It certainly can’t be due to the services and treatments needed don’t exist.

Across the United States, one thing is clear, it has everything to do with ZIP codes.

In Chicago, life expectancy can differ by as much as 16 years between just seven stops on the “L,” between the Loop and Washington Park. In Philadelphia, the 5 miles that separate Society Hill from North Philadelphia can add or subtract 20 years from your life. In New York City, if you reside near the Mets’ Citi Field, you will live on average seven years longer than if you live near Yankee Stadium. That has nothing to do with the fortunes of the teams. These are some of the dramatic findings from research conducted by the Virginia Commonwealth University Center on Society and Health and the Robert Wood Johnson Foundation.