Social Determinants of Health Goes Beyond Just Healthcare

Health care or medical care is very important for health, but it can’t be the only criteria for determining health. In 1948, the WHO defined Health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The definition is relevant however it didn’t address various factors that affect the health outcomes. 

The WHO further clarifies the definition of health as “A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”

Today the health of a community or a country is accessed by considering many factors, these factors can be grouped into five categories called as determinants of health, which includes genetics, behavior, environmental and physical influences, medical care and social factors. All these factors have a direct impact on the health of individuals. The impact of these factors can be evaluated on health by comparing various health indicators.

The social factors also called as the social determinants of health comprises a wide range of economic and social conditions prevailing in the society and country that affects the health of people and the communities. The factors considered under Social determinants of health (SDOH) include education, employment, economic policies, physical environment, social support systems, and many others. SDOH are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. 

SDOH accesses the living conditions that help in preventing morbidity and mortality, improving health, reducing the inequalities in health outcomes, and providing better health services. Overall it focuses on  the social, emotional and cultural wellbeing of the community or country. 

Some of the social and physical factors associated with the health outcomes includes: 

• Education
• Health care services 
• Healthy transport systems
• Food security
• Public Safety
• Access to technologies and other means of communication
• Employment opportunity and fair working conditions
• Social status and support policies
• Environmental Conditions such as good air quality, fresh water etc.
• And many others.

Why is SDOH important?

Social determinants of health is one of the important factors in health as it aims at achieving health equity.  “Health equity” (equity in health)‘ provides fair opportunity to attain full health potential and avoids any unfair, or remediable differences among groups of people based on their social, economical, and geographical differences. Social determinants rule out the chance of health disparities. 

If the people are provided with access to essential socioeconomic opportunities such as food security, toxin-free environments, better employment & education opportunity etc, it automatically improves their health conditions and reduces the chance of getting expensive medical services in future. The SDOH acts as an improved health equity as it focuses on all levels of governance from local to national level. SDOH builds the foundation for a social, emotional and cultural wellbeing society.

Global Plan of Action on Social Determinants of Health

At the global level WHO along with local governments, civil society, academia, donors and the private sector is working to address the Social Determinants of Health. In 2012, Canada and other United Nations (UN) Member States endorsed the “Rio Political Declaration on Social Determinants of Health” (called as Rio Declaration). 

The Rio Declaration is a non-binding pledge which calls on World Health Organization (WHO) Member States to improve/influence the working and living conditions that affect health and well-being. The Declaration focuses on five priority areas which aims to address the health inequities, the priority in the Declaration includes:

• Adopt improved governance for health and development
• Promote participation in policy-making and implementation
• Further reorient the health sector towards promoting health and reducing health inequities
• Strengthen global governance and collaboration
• Monitor progress and increase accountability

The SDOH addresses the social and economic conditions and it has the potential to further provide better health for all. However there is a need for research in the SDOH as the considered factors vary from one country to another. A country-specific conditions and design are needed in order to reduce the health disparities. Today governments worldwide, healthcare leaders, and organisations are focusing on the social determinants of health to reduce health inequality. Similarly, in the coming years technology is expected to play a key role in accessing and delivering essential services to a large population in the developing world.