Social determinants of health

Social determinants of health are a system of ideas for describing how health is socially patterned, exploring causal pathways between social conditions and human health and illness. The relationship between social determinants and chronic disease is well established. Social risk factors include person-level attributes, such as sex and gender identification, race and ethnicity, income and wealth, and educational attainment. At the population level, important determinants include political and social conditions that equitably distribute life chances in education, employment, neighborhood environment, food, housing, social inclusion, and political representation. Leverage points to address social determinants include: (1) intervene in the health-care system to reduce consequences of illness among disadvantaged people, (2) reduce the vulnerability of disadvantaged people to health-damaging factors, (3) decrease exposure to health-damaging factors associated with lower socioeconomic position, and (4) decrease social stratification. Achieving social justice requires ethical reasoning about the conditions that create substantive opportunities for health at both the individual and community levels.