Understanding Social Determinants of Health
What are social determinants of health?
According to the Word Health Organization (WHO), the 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, and the wider set of forces and systems shaping the condition of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems."
Why do SDOH matter for child health and health care?
Many SDOH factors affect how easily children can access health care. For example, research shows that about 1 in 10 people in the United States lacks health insurance. Without that coverage, children are less likely to go to primary care appointments, receive dental care or get needed medications.
The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:
- Income and social protection
- Education
- Unemployment and job insecurity
- Working life conditions
- Food insecurity
- Housing
- Basic amenities and the environment
- Early childhood development
- Social inclusion and non-discrimination
- Structure conflict
- Access to affordable health services of decent quality
Data on Health Disparities
At Nemours Children’s, we understand that learning about families’ lived experiences is crucial for improving our systems and policies. We conduct research to better understand real-life needs — not just among families who come to our clinics, but also across our communities and across the nation.
In 2019, we partnered with The Harris Poll to conduct a national survey of more than 1,000 parents of children under 18. While the range of consistent disparities that have been observed across multiple conditions is broad, including factors such as infant mortality, asthma, maternal mortality, etc., the survey drilled down and revealed some interesting statistics such as:
32% said they’ve missed at least one of their child’s medical appointments in the last year because they were unable to get to it or pay for it.
30% said they don’t have time to worry about their child’s health unless it’s a medical emergency.
23% worried they’d run out of food before getting money to buy more.
Medical care accounts for only about 15% of a family’s overall well-being. We want to redefine health and health care so that we can better meet the needs of children and their families. Find out more about our survey and redefining health for the well-being of children.
Racism and Health Disparities
Racism is one example of an SDOH. Racism, discrimination and racialized violence can profoundly impact health across a person's life. Disparities related to racism that have persisted for decades or more include infant mortality rates, maternal mortality rates, asthma disparities, cancer survivorship disparities and access to health care.
Addressing these disparities requires a wider view — we can accomplish more by looking at what happens outside our hospitals. Read more about how children’s hospitals hold the keys to creating an America Without Limits.
Children’s SDOH and Informed Health Care
Understanding the SDOH that affect our communities informs how we deliver health care. We are taking action to improve population health by:
Advocating for federal and state policies that improve the health of all children
Coupling population-based policy advocacy and programs with tools to accurately identify and address the unmet social needs of patients and families
Advocate for federal and state policies to support trauma-informed care and other strategies to address adverse childhood experiences
Leading and learning with communities across the country to design population health networks that improve health and wellbeing outcomes for all residents
Linking families with existing community resources
Advocating for policies and programs that support health care organizations in partnering effectively with community-based organizations to prevent child illness, improve health and lower health care costs