January 17, 2024

Social Determinants of Health (SDOH)

Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age. These forces and systems include a wide set of forces and systems that shape daily life such as economic policies and systems, development agendas, social norms, social policies, and political systems. CDC has adopted this definition from the World Health Organization.

Thumbnail of CDC's social determinants of health framework

Why are SDOH important to CDC?

SDOH are one of three priority areas for Healthy People 2030, along with health equity and health literacy. Healthy People 2030 sets data-driven national objectives in five key areas of SDOH: healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. Some examples of SDOH included in Healthy People 2030 are safe housing, transportation, and neighborhoods; polluted air and water; and access to nutritious foods and physical health opportunities.

As the federal government's leading public health agency, CDC has a unique role in contributing to work on SDOH.

Why is addressing SDOH important for CDC and public health?

Addressing differences in SDOH accelerates progress toward health equity, a state in which every person has the opportunity to attain their highest level of health. SDOH have been shown to have a greater influence on health than either genetic factors or access to healthcare services. For example, poverty is highly correlated with poorer health outcomes and higher risk of premature death.A SDOH, including the effects of centuries of racism, are key drivers of health inequities within communities of color. The impact is pervasive and deeply embedded in our society, creating inequities in access to a range of social and economic benefits—such as housing, education, wealth, and employment. These inequities put people at higher risk of poor health.

CDC is coordinating efforts to focus its resources on the areas where federal public health investments can make the most difference. For example, CDC's Racial and Ethnic Approaches to Community Health (REACH) focuses on reducing high rates of chronic diseases for specific racial and ethnic groups in urban, rural, and tribal communities. Since 1999, the program has worked across sectors in racial and ethnic minority communities to reduce tobacco use, improve access to healthy foods, change the built environment to promote physical activity, and connect people to clinical care.

Public health actions that affect SDOH

Public health organizations can:

Convene

Bring together community members and organizations to identify local concerns.

CDC has a long history of convening partners through national conferences, webinars, collaborative publications, and guideline development. CDC also encourages other public health organizations to act as conveners by including coalition-building or community engagement activities as a requirement in some funded projects.

Integrate

Collect and use multiple sources of data, including public health data, to help develop strategies for set direction. For example, public health departments can provide GIS maps of community needs and assets based on CDC PLACES dataB and environmental justice dataC.

Influence

Lead approaches to develop policies and solutions or leverage funding through various mechanisms to implement and expand priority actions. For example, when CDC Director Rochelle Walensky announced that racism is a public health threat in 2021, it reinforced actions that communities were already taking and supported many others as they took subsequent actions.

Contribute to big changes

Collaborate with others to find innovative solutions and put them into place. For example, an LA County public health initiative resulted in the ban of menthol cigarettes.