Social Determinants of Health: A Primer

Private equity firms, by their nature, focus on maximizing returns. But what if key factors influencing a company's workforce, and likely its bottom line, have been overlooked? Enter the social determinants of health (SDoH).

Traditionally, health outcomes in the US have been viewed through a medical lens: disease diagnosis, treatment, and access to care. However, SDoH paint a broader picture. These are the social and economic conditions that shape where we live, learn, work, and play, and they have a profound influence on our health. 

Numerous studies estimate that SDoH account for up to 80% of health outcomes, exposing a fundamental truth: your zip code can often be a stronger predictor of health than your genetics.

These social determinants can be broken down into five categories: 

  1. Economic Stability: Income, employment opportunities, and social protection systems all impact a person’s health. Financial stress can lead to chronic illness, while secure employment often provides access to health insurance.
  2. Education: Quality education throughout life is linked to better health outcomes. Educational attainment influences health literacy, ability to manage chronic conditions, and job opportunities with better health benefits and fewer safety risks. 
  3. Social and Community Context: Social support networks, exposure to violence, and discrimination all play a role. Strong social connections promote mental and physical well-being, while chronic stress from discrimination can have a negative impact.
  4. Neighborhood and Built Environment: Safe housing, access to green spaces, and walkable neighborhoods encourage physical activity and healthy living. Conversely, poor housing conditions and environmental pollution contribute to health problems.
  5. Healthcare Access and Quality: Health insurance coverage, transportation barriers, and cultural competency of providers can all affect timely access to healthcare services. When healthcare costs are prohibitive, people may forgo necessary care and medications altogether, potentially leading to more serious health problems in the future.
The interactive ecosystem of the Social Determinants of Health (WEF 2021)
Investing in Addressing Social Determinants to Improve Health, World Economic Forum, 2021

SDoH expose the root causes of health disparities. They explain why someone living in a neighborhood with high levels of air pollution develops respiratory issues, even if they prioritize healthy habits and avoid smoking. This isn't simply a matter of individual choices; it's about the environment shaping those choices.

People living in disadvantaged communities often face a multitude of negative SDoH, like inadequate housing, food insecurity, and exposure to violence. These negative SDoH don't exist in isolation; they reinforce each other. While disadvantaged communities often have fewer resources to address these challenges, they also often struggle with limited access to quality healthcare. This lack of access further perpetuates health inequities and widens the gap in outcomes between disadvantaged and advantaged communities.

Understanding these SDoH are crucial for achieving health equity – where everyone has a fair shot at reaching their best health. It forces us to recognize that improving health outcomes requires creating an environment where everyone has the chance to thrive. By understanding this root cause, we can start to address the disparity. 

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