What are Social Determinants of Health?
Social determinants of health (SDOH) are the conditions in the environments where 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. SDOH impact nearly everyone in one way or another, and simply promoting healthy choices won’t eliminate health disparities. Considering the unique environments, cultures, histories, and circumstances of racial and ethnic minority and American Indian/Alaska Native (AI/AN) populations is fundamental to improving health outcomes and reducing longstanding disparities and inequities.
Racial and ethnic minority populations throughout the United States experience higher rates of death and disease across a wide range of health conditions when compared to their white counterparts. Data analysis from 2022 found that adverse SDOH and health-related social needs were significantly higher across all other racial and ethnic groups except non-Hispanic Asian adults when compared with their white counterparts. Longstanding inequities in the five domains of SDOH influence a wide range of health risks and quality-of-life outcomes.
Non-medical factors like poverty, limited access to healthcare, lack of education, and racism are all examples of individual SDOH that contribute to health disparities and inequities. SDOH can be grouped into five domains. Click on the headings below to learn more about them and their impact on racial and ethnic minority populations:
Economic stability is a major social determinant of health. It refers to having a steady income and enough resources to meet basic needs such as food, housing, healthcare, and transportation. People with economic stability are more likely to have good health outcomes, while those who are struggling financially are more likely to experience health problems.
Access to educational resources and quality education can play significant roles in health. Education equips individuals with the knowledge and skills to understand health information and make informed decisions about their health and the healthcare system. There is a strong correlation between education and healthy habits. People with lower educational attainment may have difficulty securing stable, well-paying jobs. This can lead to financial strain and limit access to healthcare, potentially increasing the risk of chronic health issues like heart disease, diabetes, and depression.
Healthcare access and quality of care are fundamental social determinants of health. Geographic proximity, affordability, and availability of healthcare providers all influence how easily people can get the care they need. Approximately 10% of the U.S. population does not have health insurance, which can prevent individuals from seeking out healthcare services. Difficulty navigating the healthcare system and lack of culturally and linguistically appropriate care providers can also affect access to quality care.
Social connections matter. Relationships with family, friends, and community provide support, reduce stress, and influence healthy behaviors. Strong social connections and a sense of belonging within a community foster well-being. Discrimination, unsafe neighborhoods, and lack of resources can hinder getting the social support needed for good health. Programs to address SDOH can create supportive environments and improve overall health outcomes.
Neighborhoods play a key role in health. Where you live can significantly impact your health and well-being. Many factors, like crime rates, access to healthy food, and green spaces can influence health outcomes. Unfortunately, racial and ethnic minorities and low-income residents are more likely to live in neighborhoods with higher health risks. Interventions like creating walkable communities can improve health and safety for all.
The relationship between SDOH and health disparities and inequities is complex and multilayered. Many health disparities affecting racial and ethnic minority and AI/AN people are often the result of or exacerbated by multiple SDOH factors. For example, childhood poverty combined with crowded housing was associated with a 41% higher risk for premature death, and early poverty combined with separation from a parent was associated with a 50% increase in premature death. By addressing SDOH through a comprehensive approach, we can work to advance health equity and reduce health disparities among vulnerable populations.
Taking Action
Public health and community-based organizations can take steps to start improving the health of their communities by addressing SDOH. Organizations can leverage these steps (Adapted from guidance provided by the Centers for Disease Control and Prevention) to Be the Source for Better Health in your communities:
Convene
Bring together members of your community and trusted organizations to identify concerns specific to your community.
National Minority Health Month Events
See what events are taking place this year for National Minority Health Month and learn how you can get your community involved.
The Community Engagement Playbook
A playbook to guide public health professionals, and state, territorial, local, and tribal partners through four phases and nine key activities of community engagement.
Health Literacy Activities by State
The links on this page include state and local collaborations and academic, government, and non-profit organizations with a health literacy focus. They exemplify goals in the National Action Plan to Improve Health Literacy - PDF. Specifically, they cross organizational boundaries, provide new knowledge to the field, or convene diverse groups and people with an interest in health literacy.
Consider
Collect and utilize multiple sources of data and information, including public health data, to help develop strategies that can benefit you and your community.
OMH Population Profiles
These profiles provide detailed demographic, language fluency (where relevant), education, economic, insurance coverage, and health status information, as well as full census reports.
National Minority Health Month Reading List
This brief bibliography developed by the OMH Knowledge Center contains free resources available to read and download focused on health disparities in racial and ethnic minority populations.
PLACES: Local Data for Better Health
PLACES provides health data for small areas across the country. This allows local health departments and jurisdictions to better understand the burden and geographic distribution of health measures in their areas and assist them in planning public health interventions, regardless of population size and rurality.
National Center for Health Statistics (NCHS)
NCHS is the nation’s principal health statistics agency. They compile statistical information to guide actions and policies to improve the health of populations and communities.
Commit
Committing to providing Culturally and Linguistically Appropriate Services (CLAS) is one way to help eliminate health inequities. Effective, equitable, and respectful care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, economic and environmental circumstances, and health literacy levels are essential to close the gap in health outcomes for racial and ethnic minority populations.
Think Cultural Health
Think Cultural Health is an OMH initiative that provides health and healthcare professionals with information, continuing education opportunities, and resources to learn about and implement CLAS and the National CLAS Standards.
Agency for Healthcare Research and Quality (AHRQ)
AHRQ has tools, training, and reports to help health systems deliver CLAS so that all patients receive high quality care and achieve good health outcomes.
Create a Health Literacy Plan
Health literacy is connected to health equity. If you want to be able to identify concerns and make health information more accessible, understandable, and usable for your community, you need a plan. The resources found here can walk you through the planning process of how to improve health literacy so that you can offer accurate, accessible, and actionable health information to your community.
Collaborate
Work with trusted partners to address the impact of SDOH on vulnerable populations and to find innovative solutions that can be put into action. Mobilize partners to develop and implement strategies addressing health disparities and long-standing inequities.
Offices of Minority Health and Health Equity at HHS
OMH is one of eight offices of minority health within the U.S. Department of Health and Human Services. The Office works with local and federal partners to eliminate health disparities while improving the health of people from all minority populations, including people from racial and ethnic minorities; people with disabilities; members of the lesbian, gay, bisexual, and transgender community; individuals with limited English proficiency; and rural communities. See how other offices of minority health are working to lead and coordinate activities that improve the health of racial and ethnic minority populations and reduce health disparities:
- Agency for Healthcare Research and Quality (AHRQ)
- Centers for Disease Control and Prevention (CDC)
- Centers for Medicare & Medicaid Services (CMS)
- Food and Drug Administration (FDA)
- Health Resources and Services Administration (HRSA)
- National Institute on Minority Health and Health Disparities (NIMHD)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
Stay Connected with OMH
Stay connected and participate in conversations about health equity on social media by tagging @MinorityHealth and using the hashtags #SourceForBetterHealth, #MinorityHealth, and #NMHM24. on:
Subscribe to OMH E-newsletters
- The FYI Weekly Health Resources newsletter is an email bulletin with links to information on grants, fellowships and scholarships, program resources, events, and more.
- The Health Equity Link is a monthly newsletter for public health, health care and service professionals, and consumers that highlights news, campaigns, events, and programs of interest.