Social determinants of health

The social determinants of health are the everyday conditions of people's lives, rather than their genes or medical care, that influence how healthy they are and how long they live. They include the circumstances of birth and childhood, schooling, jobs and income, housing, transport, neighborhood safety, access to nutritious food, clean air and water, and access to health care, along with discrimination and social support. Behind them lie the wider forces that distribute money, power and resources across a society.

Research shows these factors can matter more for health than genetics or access to health care. They help explain health inequities, which are differences in health between groups that are unfair and avoidable. Health follows a social gradient: at every income level, people lower on the socioeconomic ladder tend to have worse health than those above them, and average life expectancy differs by many years between the richest and poorest countries. Someone who lives far from any store selling fresh food, for example, faces a higher risk of diabetes, obesity and heart disease.

The US Healthy People 2030 framework groups the determinants into five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.