Social Determinants Of Health Equity

Health is often defined by access to health care services. While access to affordable health care is necessary, it’s important to recognize that health and wellness are largely determined by the environments and conditions we live in. A number of studies point to the impact of place on life expectancy. We often hear that one’s zip code is more important than their genetic code when it comes to a long healthy life.

The figure below shows differing life expectancies between central Washington D.C. and the suburbs, which tend to have higher median incomes and fewer residents of color.

Leaving the city center, life expectancies tend to increase. This trend holds across many US cities. What is it about these places that determines life expectancy?  

Research points to a discrete set of factors that help to determine health and life expectancy.  These “ingredients” are referred to by public health professionals as the social determinants of health (SDOH).  These are the social and environmental conditions that we experience on a daily basis—the conditions where we play, learn, sleep, work, seek care, and age.

Identity, including race, gender, socioeconomic status, and sexual orientation, combined with historical discrimination and oppressive policies, also influences how robustly present or absent each determinant is. People of color, women, LGBTQ folks, undocumented people, working class families and individuals, indigenous communities, and individuals with disabilities disproportionately bear the burden of poor policy and program decisions. While folks can organize to improve many determinants of health, they cannot change their ethnicity, race, gender, orientation, or other identity characteristics.

Despite many factors disproportionately impacting our communities and resulting in poor health, community resilience continues to elevate successful and innovative strategies to improve health everyone.  Communities across the U.S. organize and educate residents around the root causes, or social determinants of health, shaping the local social conditions to promote better health for all.

Praxis is proud to work with a number of community groups across the U.S. that are working across and at the intersection of these determinants to help advance the cause of health justice for all.

Some of the key social determinants for a healthy childhood are included in the adjacent chart, and in the interactive grid below: