SOCIAL DETERMINANTS

OVERVIEW

The concept of social determinants recognizes the critical role of home, school, workplace, neighborhood, and community in improving health. Social determinants are in part responsible for the unequal and avoidable differences in health status within and between communities. Individual and population health are affected by a range of personal, social, economic, and environmental factors. For example, people with a quality education, stable employment, safe homes and neighborhoods, and access to preventive services tend to be healthier throughout their lives.

CHILDREN

Early and middle childhood provide the physical, cognitive, and social-emotional foundation for lifelong health, learning, and well-being. A history of exposure to adverse experiences in childhood, including exposure to violence and maltreatment, is associated with health risk behaviors such as smoking, alcohol and drug use, and risky sexual behavior, as well as health problems such as obesity, diabetes, heart disease, sexually transmitted diseases, and attempted suicide.6
Features of the built environment, such as exposure to lead-based paint hazards and pests, negatively affect the health and development of young children.

ADOLESCENTS

Because they are in developmental transition, adolescents and young adults are particularly sensitive to environmental influences. Environmental factors, including family, peer group, school, neighborhood, policies, and societal cues, can either support or challenge young people’s health and well-being. Addressing young people’s positive development facilitates their adoption of healthy behaviors and helps to ensure a healthy and productive future adult population.
Adolescents who grow up in neighborhoods characterized by poverty are more likely to be victims of violence; use tobacco, alcohol, and other substances; become obese; and engage in risky sexual behavior.7

ADULTS

Access to and availability of healthier foods can help adults follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a person’s diet. These venues may be less available in low-income or rural neighborhoods.
Longer hours, compressed work weeks, shift work, reduced job security, and part-time and temporary work are realities of the modern workplace and are increasingly affecting the health and lives of U.S. adults. Research has shown that workers experiencing these stressors are at higher risk of injuries, heart disease, and digestive disorders.

OLDER ADULTS

Availability of community-based resources and transportation options for older adults can positively affect health status. Studies have shown that increased levels of social support are associated with a lower risk for physical disease, mental illness, and death