Social Determinants of Health: Key Concepts and Research Studies

Social Determinants of Health

Conditions in which people are born, live, work, and age that impact health

Economic Stability

Income, employment, financial security

Education Access & Quality

Schooling, literacy, education level

Healthcare Access & Quality

Insurance, access to providers, quality care

Neighborhood & Built Environment

Housing, safety, environment, transportation

Social & Community Context

Relationships, support systems, discrimination

Justice as Fairness (Rawls)

Society should be structured to ensure fairness

Rawls' Key Ideas

Equal basic rights (freedom, participation), Equal opportunity for all, Inequalities are only okay if they benefit the least advantaged

Daniels (applies Rawls to health)

Health is necessary for equal opportunity

Daniels' Key Takeaways

Society must provide: Access to healthcare, Resources like education & childcare; Focus should NOT just be profit → should reduce health inequalities

Whitehall I (1978)

British civil servants (all employed, not poor); Lower job status = higher death rates

Whitehall II

Same results (even with women included)

Whitehall Main Finding

Health follows a social gradient; Lower status = worse health; NOT just income → position in hierarchy matters most

CARDIA (U.S. study)

Looked at race + socioeconomic status

CARDIA Main Findings

Lower social status = Worse self-rated health, Higher depression, Higher hypertension (most groups)

CARDIA Trend

Effects weaker in some groups, but trend still exists