Social Determinants of Health

The concept of Social Determinants of Health (SDH) is complicated and fluid resulting in a wealth of literature and perspectives on what make up SDHs and how they impact individuals, communities, and populations. The needs to address pervasive health disparity weaves its way through almost all the following resources, addressing the impacts of socioeconomic status, race/ethnicity, gender identity, education, income, perceived wellness, and historical climate, all of which shape healthcare access, decision making processes and health outcomes

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In 2010 the World Health Organization published a comprehensive look at health inequity on a global scale addressing all the above mentioned SDH and breaking them down and evaluated at a macro and micro level. It goes on to make propositions to reduce the health inequity due to SDHs.

World Health Organization. (2010). A Conceptual Framework for Action on the Social Determinants of Health. Commission on Social Determinants of Health, Switzerland. iris.who.int/bitstream/handle/10665/44489/?sequence=1

Systemic racism contributes to poor health outcomes and experiences. This paper elaborates on the components which promote culturally safe healthcare: cultural awareness, cultural sensitivity, and cultural safety. It encourages emphases the need for continuing education of healthcare providers on the historical implications resulting in systemic racism with a focus on self-reflection and accountability.

Frawley, J., Russell, G., Sherwood, J. (2022). Cultural Competence and the Higher Education Sector: Australian Perspectives, Policies, and Practices. Springer Nature Singapore Press Ltd. Singapore. P. 164-173. https://doi.org/10.1007/978-981-15-5362-2_9

Health literacy is a fundamental right as it enables access to resources and decision-making skills which influence health. Literacy can be improved with public health education initiatives focusing on critical thinking skills and skill-based knowledge. For more information on the importance of literacy, its impact on social determinant of health and how it can be improved, check out this article by Nutbeam & Lloyd (2021) and the Organization for Economic Co-Operation and Development's 17 Goals

Nutbeam, D. & Lloyd, J.E. (2021). Understanding and Responding to Health Literacy as a Social Determinant of Health. Annual Review of Public Health: 42: 159-173. https://doi.org/10.1146/annurev-publhealth-090419-102529

Health Literacy is an unequivocal determinant of health which impacts individual and community accessibility to health information, resources, and services, while simultaneously diminishing their power to make informed autonomous medical decisions. Community and educational initiatives are required to improve population literacy rates, but effort must also be simplify the health care system so that populations with lower literacy rates can navigate the healthcare system with dignity.

Health Literacy has been considered an individual trait, however research is showing the impacts from a systemic and larger scale picture. Lower health literacy rates negatively and disproportionately affect certain individuals and demographics resulting in more challenging navigation of the health care system and increased burden on resources. This detailed article by Palumbo (2016) sheds light on the importance of designing health care systems which are accessible to all levels of literacy.
Palumbo R. 2016. Designing Health-Literate Health Care Organization: A Literature Review. Health Services Management Research. 29(3):79–87. https://doi.org/10.1177/0951484816639741

From the Government of Canada, this accessible resource highlights SDoH and how they influence individual health at a tangible level

Public Health Agency of Canada. (2013, January 15). What Makes Canadians Healthy or Unhealth? Canada.ca. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health/what-makes-canadians-healthy-unhealthy.html