Where does health begin? You might think it starts with a productive daily routine, at the gym or maybe even at the doctor’s office. But our health is actually formed much earlier – and reinforced more regularly – than you might expect. According to the principles of the social determinants of health, our health outcomes are determined and supported by the conditions in which we grow, live, work, learn and socialize. This means that health starts in our homes, neighborhoods, social circles, schools and workplaces, and unfortunately the result is glaring disparities in health outcomes across different populations.
The term social determinants of health has been gaining traction in the media due to recent events centered around social justice, and for good reason. According to Dr. Dexter Shurney, President of The American College of Lifestyle Medicine and Chief Medical Officer at Foodsmart by Zipongo, systemic racism is a major contributor to disadvantageous health behaviors that lead to long-term ill-health.
Discrimination impacts health at both the structural and individual levels, resulting in unmet basic needs like quality education, safe housing, a social support network, transportation and food security, which in turn increases the risk of poor health outcomes. In a 2019 survey conducted by McKinsey, of the respondents who disclosed multiple unmet needs (with food security being the most common), 45% also self-reported poor physical health, poor mental health and higher utilization of healthcare services.
“We need to invest more in health and not just healthcare.” – Dr. Dexter Shurney
Chronic conditions are more prevalent within minority ethnic populations, with a 1.5-2x greater likelihood of developing a major condition like type 2 diabetes, heart disease or high blood pressure. Additionally, low-income adults in the U.S. experience higher rates of these same chronic conditions when compared to their higher-income counterparts, indicating that the structural racial inequities are not only impacting initial health outcomes but also one’s ability to prevent, reverse or properly manage lifestyle-related diseases. This is especially concerning with the increased risk of hospitalization or death from COVID-19 for those with preexisting conditions.
These social determinants can have serious implications for mental health outcomes, too. A report issued by the World Health Organization (WHO) found a correlation between social inequality and increased risk of a variety of common mental health disorders like anxiety, depression, substance abuse and schizophrenia. If that’s not enough, depression is the leading cause of disability and disease burden across the globe, underscoring the severity of poor mental health and its far-reaching effects on an individual’s overall health and wellbeing. When we factor in societal stigma, limited or no access to mental health services or health insurance, lack of transportation, scheduling issues or lack of education prohibiting self-awareness when it comes to identifying mental health needs, it’s easy to see how the social determinants of health heavily contribute to the global mental health crisis.
Fortunately, there are steps that organizations can take today to combat the effects of these social determinants of health. While diversity and inclusion efforts should be a priority for employers, impactful change cannot be made without a focus on health equity. Download our quick read for expert advice from Dr. Aletha Maybank to learn how your organization can create a culture that provides the conditions, resources, opportunities and power to achieve optimal health for all.