What are the pictures that come to mind when you hear the word “health?” Typical visuals tend to depict doctor visits, healthy eating and exercise. What would you say if you were told that employment, stable housing and civic participation could be just as important as checking your blood pressure?

Recent research has shown that there are many factors beyond personal and physical health which are just as important for individual health outcomes, these are called the Social Determinants of Health (SDOH). To put it simply, social determinants of health are factors external to a person’s physical state of well-being that can impact their short- and long-term health outcomes. But what is meant by ‘social determinants’ and how can they be categorized in order to best understand our ability to control factors that influence our physiological well-being?  

SDOH: an official definition: 

Most of the foundational research on the social determinants of health comes from the Center for Disease Control (CDC). Here’s the CDC’s official definition: “social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.”

The CDC has organized the SDOH into five key areas

  • Economic Stability 
  • Education 
  • Social and Community Context 
  • Health and Health Care 
  • Neighborhood and Built Environment

To break it down even further, each of these areas reflect a number of key issues that make up the underlying factors of SDOH. This provides a robust framework for organizing areas that are not only relevant, but interdependent within each of the social determinant key areas. This isn’t an exhaustive list and it is being refined as more studies are conducted. 

Here are the key issues within each key area of SDOH:

  • Economic Stability 
    • Employment 
    • Food Insecurity 
    • Housing Instability 
    • Poverty
  • Education 
    • Early Childhood Education and Development 
    • Enrollment in Higher Education 
    • High School Graduation 
    • Language and Literacy 
  • Social and Community Context 
    • Civic Participation 
    • Discrimination 
    • Incarceration 
    • Social Cohesion 
  • Health and Health Care 
    • Access to Health Care 
    • Access to Primary Care 
    • Health Literacy 
  • Neighborhood and Built Environment 
    • Access to Foods that Support Health Eating Patterns 
    • Crime and Violence 
    • Environmental Conditions 
    • Quality of Housing 

Here are a few quick examples of how these key SDOH issues play out in real people’s lives. Hopefully, these examples will help illuminate how the factors listed above could affect a person’s health outcomes.  

  • Employment: The nature of an individual’s job or place of employment could require them to face physical and chemical hazards, physically strenuous tasks or psycho-social factors (power dynamics, respect, etc.). 
  • Education: An individual’s education directly affects their ability to secure quality employment, their earning potential and their access to resources. 
  • Social Exclusion: Individuals or groups may perceive differing levels of the presence or absence of both social influence and social mobility. 
  • Public Health: Individuals may experience systemically-driven health issues like diabetes, food insecurity, unintended pregnancy or mental health challenges. 
  • Gender Equity: Different gender identities face disparate social and economic vulnerability and are differently affected by unintended pregnancies and access to prenatal care. 
  • Early Childhood Development: Children may experience malnutrition, be subjected to ongoing Adverse Childhood Experiences or have poor access to quality education.
  • Health Care: Individuals face issues with healthcare affordability, quality and accessibility.  
  • Quality of Housing: Urbanization has led to spatial pockets of poor housing quality, pollution and resident exposure to toxic agents.

Social Determinants and United Way of Greater Chattanooga

You may have noticed already that United Way’s focus on education, health and stability and sub-initiatives within those categories align very closely with the SDOH key areas and their sub-issues. The Social Determinants of Health outline how health is dependent on more than blood-work and diet and consider the variety of factors that contribute to personal success. By taking the time to learn more about the SDOH and related factors, we are able to move one step further in advocating for and supporting those most heavily impacted in our community. 
As you look for ways to support the health of your neighbors in Greater Chattanooga, we invite you to give to a network of nonprofits who are addressing many of the key areas mentioned above. Take the next step today by giving to our community investment fund. United, we can fight for the health of every member of our community, regardless of background or zipcode.