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What are ‘social determinants of health’?


Put simply, social determinants of health (SDoH) are the “causes behind the causes”. The upstream social and economic factors that largely but insidiously dictate the health - and disease - of individuals and populations. The notion recognises that the conditions in which we live, work, learn and play all heavily influence the health we can achieve.

SDoH include access to education, transport, quality housing, employment opportunities and freedom from discrimination. The World Health Organization explains that these social and economic conditions, and their effects on people’s lives, determine our risk of illness; the actions we can take to prevent ourselves becoming ill; and our ability to treat illness when it occurs.

Think of social determinants as the root-causes of health and disease.

Imagine a bucket full of health. This bucket has a hole in the bottom and the health is dripping out (disease). We can mop up the floor below every hour, maybe even squeeze some of the health back into the bucket from the mop. But eventually, the health will be lost because we are not addressing the root of the problem. Instead, we can look for ways to prevent the hole and stop the leak from occurring.

In the same way, addressing SDoH works on the causes of the loss in health in our society. We can continue to only treat the rising burden of diabetes and heart disease (which of course is still an important social investment), or we can also address issues such as the lack of education around prevention, rising mental health burden caused by economic and social hardships and tackle unaffordable housing and health care.

Which will in turn, lead to greater community health.

Still confused? Watch this fantastic clip from Canada that explains all…


For more on global health, explore Translational Global Health, from Alessandro and PLOS.

Join the conversation

5 Comments sorted by

  1. David Thompson

    Science Communications at Hawkesbury Institute for the Environment (UWS) at University of Western Sydney

    The Canadians have invested considerable effort in applying a better understanding of SDOH in various ways. Understanding of the need to make it relevant to everyday people is important in creating actions to improve health befire it becomes disease-oriented.

  2. Jeremy Dawson


    This topic was the subject of one of the Christians for an Ethical Society forums earlier this year,titled FREEDOM to lead a life we have reason to VALUE: the social causes of HEALTH & WELLBEING":by Professor Sharon Friel. We have online links to copy of the talk and other related articles, etc, see -> CES Forums
    and scroll down to the second one listed.

  3. Tom Hennessy


    The ability to intercede in the pandemic of disease in man is hampered by laws which govern ones' ability to speak out against a food , evidenced by Oprah and her 'run in' with the Cattleman's Association and being sued for millions for saying she won't be eating burgers.
    Doctors first should explain why animals do not manifest disease anywhere close to man THEN they might be taken seriously .
    Until then mankind will continue to exponentially manifest genetic mutation and chronic disease until we will be unrecognisable , IE: Rue Paul

  4. Daniel Clark

    Team Leader Leisure Development - Knox City Council

    Brilliant video!