Unit 1: Determinants of Health

Question 1

What are the social determinants of health?

Answer 1

Conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life-risks and outcomes

Question 2

SDOH Domains

Answer 2

• Economic Stability
• Health Care Access and Quality
• Social and Community Context
• Educational Access and Quality
• Neighborhood and Built Environment

Question 3

Economic Stability (SDOH Domain)

Answer 3

• The connection between the financial resources people have such as income, cost of living, socioeconomic status, and their health. This area includes key issues such as poverty, employment, food security, and housing stability.
• Help people earn steady incomes that allow them to meet their health needs

Question 4

Health Care Access and Quality (SDOH Domain)

Answer 4

• The connection between people’s access to and understanding of health services and their own health. This domain includes key issues such as access to healthcare, access to primary care, health insurance coverage, and health literacy.
• Increase access to comprehensive, high-quality health care services

Question 5

Social and Community Context (SDOH Domain)

Answer 5

• The connection between characteristics of the context within which people live, learn, work, and play, and their health and wellbeing. This includes topics like cohesion within a community, civic participation, discrimination, conditions in the workplace, and incarceration.
• Increase social and community support (positive living situations and healthy relationships)

Question 6

Education Access and Quality (SDOH Domain)

Answer 6

• The connection of education to health and wellbeing. This domain includes key issues such as graduating from high school, enrollment in higher education, educational attainment in general, language and literacy, and early childhood education and development.
• Increase educational opportunities and help children and adolescents do well in school

Question 7

Neighborhood and Built Environment (SDOH Domain)

Answer 7

• The connection between where a person lives- housing, neighborhood, and environment, and their well being. This includes topics like quality of housing, access to transportation, availability of healthy foods, air and water quality, and neighborhood crime and violence.
• Create neighborhoods and environments that promote health and safety

Question 8

Facts about Economic Stability Domain

Answer 8

• In the United States, 1 in 10 people live in poverty, and many people can’t afford things like healthy foods, health care, and housing. Healthy People 2030 focuses on helping more people achieve economic stability.
• People with steady employment are less likely to live in poverty and more likely to be healthy, but many people have trouble finding and keeping a job. People with disabilities, injuries, or conditions like arthritis may be especially limited in their ability to work. In addition, many people with steady work still don’t earn enough to afford the things they need to stay healthy.
• Employment programs, career counseling, and high-quality child care opportunities can help more people find and keep jobs. In addition, policies to help people pay for food, housing, health care, and education can reduce poverty and improve health and well-being.

Question 9

Facts about Health Care Access and Quality Domain

Answer 9

• Many people in the United States don’t get the health care services they need.
• -Healthy People 2030 focuses on improving health by helping people get timely, high-quality health care services.
• About 1 in 10 people in the United States don’t have health insurance.
• -People without insurance are less likely to have a primary care provider, and they may not be able to afford the health care services and medications they need.
• -Strategies to increase insurance coverage rates are critical for making sure more people get important health care services, like preventive care and treatment for chronic illnesses.
• Sometimes people don’t get recommended health care services, like cancer screenings, because they don’t have a primary care provider. Other times, it’s because they live too far away from health care providers who offer them.
• -Interventions to increase access to health care professionals and improve communication — in person or remotely — can help more people get the care they need.

Question 10

Facts Social and Community Context Domain

Answer 10

• People’s relationships and interactions with family, friends, co-workers, and community members can have a major impact on their health and well-being. Healthy People 2030 focuses on helping people get the social support they need in the places where they live, work, learn, and play.
• Many people face challenges and dangers they can’t control — like unsafe neighborhoods, discrimination, or trouble affording the things they need. This can have a negative impact on health and safety throughout life.
• Positive relationships at home, at work, and in the community can help reduce these negative impacts. But some people — like children whose parents are in jail and adolescents who are bullied — often don’t get support from loved ones or others. Interventions to help people get the social and community support they need are critical for improving health and well-being.

Question 11

Facts about Educational Access and Quality Domain

Answer 11

• People with higher levels of education are more likely to be healthier and live longer. Healthy People 2030 focuses on providing high-quality educational opportunities for children and adolescents — and on helping them do well in school.
• Children from low-income families, children with disabilities, and children who routinely experience forms of social discrimination — like bullying — are more likely to struggle with math and reading. They’re also less likely to graduate from high school or go to college. This means they’re less likely to get safe, high-paying jobs and more likely to have health problems like heart disease, diabetes, and depression.
• In addition, some children live in places with poorly performing schools, and many families can’t afford to send their children to college. The stress of living in poverty can also affect children’s brain development, making it harder for them to do well in school. Interventions to help children and adolescents do well in school and help families pay for college can have long-term health benefits.

Question 12

Facts about Neighborhood and Built Environment Domain

Answer 12

• The neighborhoods people live in have a major impact on their health and well-being.
• Healthy People 2030 focuses on improving health and safety in the places where people live, work, learn, and play.
• Many people in the United States live in neighborhoods with high rates of violence, unsafe air or water, and other health and safety risks. Racial/ethnic minorities and people with low incomes are more likely to live in places with these risks. In addition, some people are exposed to things at work that can harm their health, like secondhand smoke or loud noises.
• Interventions and policy changes at the local, state, and federal level can help reduce these health and safety risks and promote health. For example, providing opportunities for people to walk and bike in their communities — like by adding sidewalks and bike lanes — can increase safety and help improve health and quality of life.

Question 13

Social determinants of health (SDOH) have a major impact on people’s health, well-being, and quality of life.
Examples of SDOH include:

Answer 13

• Safe housing, transportation, and neighborhoods
• Racism, discrimination, and violence
• Education, job opportunities, and income
• Access to nutritious foods and physical activity opportunities
• Polluted air and water
• Language and literacy skills

Question 14

How Does Healthy People 2030 Address SDOH?

Answer 14

• One of Healthy People 2030’s 5 overarching goals is specifically related to SDOH:
• -“Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.”
• In line with this goal, Healthy People 2030 features many objectives related to SDOH.
• -Objectives highlight the importance of “upstream” factors) usually unrelated to health care delivery) in improving health and reducing health disparities.
• More than a dozen workgroups made up of subject matter experts with different backgrounds and areas of expertise developed these objectives. One of these groups, the Social Determinants of Health Workgroup, focuses solely on SDOH.

Question 15

CDC Research on SDOH

Answer 15

Research by CDC authors on a range of SDOH topics expands the scientific evidence that will help build the pathway to health equity,

Question 16

How can addressing social determinants of health improve health?

Answer 16

-Resources that enhance quality of life can have a significant influence on population health outcomes. 
Examples of resources:
-Safe and affordable housing
-Access to education
-Public safety
-Availability of healthy foods
-Local emergency/health services
-Environments free of life-threatening toxins.

Question 17

Healthy People 2030

Answer 17

• Highlights the importance of addressing SDOH by including “social and physical environments that promote good health for all” as one of the four overarching goals for the decade.
• We also know that poverty limits access to healthy foods and safe neighborhoods and that more education is a predictor of better health. Differences in health are striking in communities with poor SDOH such as unstable housing, low income, unsafe neighborhoods, or substandard education. By applying what we know about SDOH, we can not only improve individual and population health but also advance health equity.