Anna, who is twelve, has asthma. She receives her medical care in a clinic connected to an academic hospital while living in a low-income area. Even with competent medical care, Anna’s asthma continues to be not well under control. She missed over two weeks of school last year, went to the emergency room twice, and had a brief but harrowing (and costly) hospital stay. Her pediatrician thinks that Anna’s family’s outdated, rent-subsidized apartment might be contributing to the issue: Her asthma attacks may be brought on by things like mold, moisture, mice, and dust mites, but these things are outside the purview of physician management.

Situations like Anna’s (a composite illustration) are a significant contributor to the deteriorating health and increasing health care costs in the United States. Living conditions that are unhealthy, poor nutrition, and a variety of social and environmental factors can make previously treatable health problems expensive for both patients and providers.  Mental health concerns are also a factor with all this change.  Research has shown that it is estimated that more than one in five U.S. adults live with a mental illness (57.8 million in 2021) and an estimated 49.5% of adolescents had any mental disorder.  Now, what are some things causing this change??  One major factor would be Social Determinants Of Health (SDOH). 

What are SDOH?

First, what are social determinants of health?? So glad you asked. They are the factors in a person’s life that have an effect on their health and wellbeing.  This includes the ease with which someone may acquire healthcare, education, a secure place to live, and nourishing food, also consisting of political, social, and cultural elements.

What are the classifications of Social Determinants of Health (SODH)?

The following classify the different SODHs: 

Economic Stability –

This refers to the relationship between a person’s financial situation and their physical well-being.  Poverty, employment, food security, and housing stability are a few examples of this aspect. 

A shocking statistics is: In the United States, 1 in 10 people live in poverty and many people can’t afford things like healthy foods, healthcare, and housing.

Education – 

This group focuses on the relationship between a person’s health and their access to and quality of education. Secondary education, higher education, language literacy, and childhood development are a few examples of education.  People with higher levels of education are more likely to be healthier and live longer.  Without education, an individual is more likely to experience health problems like heart disease, diabetes, and depression and the stress of living in poverty can also affect children’s brain development, making it difficult for them to do well in school.

Healthcare – 

This refers to a person’s access to healthcare and its quality.  Access to primary healthcare, health insurance coverage, and health literacy are examples of this group.  

Some astounding statistics are in 2021, 28.1 million (8.6%) people of all ages were uninsured at the time.  Individuals without insurance were found to experience a barrier to health in the past year due to a social need, while 21% of them prioritized paying for food or rent over seeing a doctor or getting medication according to the National Health Interview Survey performed by the National Center for Health Statistics in 2021.  

Neighborhood, and Built Environment –

This category takes into account a person’s dwelling and surroundings as well as the influence they have on their health.  Housing quality, availability of nutritious meals, transportation, the quality of the water nearby, crime, and violence are all factors.  

Among 1,006 participants in the KRC Research conducted by Kaiser Permanente in 2019, 39% reported experiencing stress frequently or occasionally related to providing their family with nutritious meals, 35% related to housing needs, and 32% related to transportation needs.  The CDC asserts that a person’s health and wellbeing are significantly impacted by the community they reside in.

Social and Community –

This category focuses on how a person’s lifestyle—their manner of living, working, playing, and learning—relates to their health. Civic engagement, discrimination, incarceration, and employment circumstances are among the factors.  

According to the CEA report: Economic Perspectives on Incarceration and the Criminal Justice System report, the incarceration rate in the U.S. grew more than 220% between 1980 and 2014, though crime rates have fallen and over 50 percent of the incarcerated have mental health problems, while approximately 70 percent were regular drug users and 65 percent regularly used alcohol prior to being incarcerated. This is astounding!  

Why Is This Important To Know?

Social determinants of health have the power to improve or deteriorate the health of an individual and a community. Health behaviors and biological factors that are a part of a person’s unique lifestyle and genetic make-up are frequently impacted by factors of SODH.

These variables are what the World Health Organization refers to as “health inequities” – the unfair and unavoidable differences in health status. Many ingrained global “health inequalities” are thought to be influenced by these factors; including lower life expectancy, higher rates of infant mortality, and a heavier burden of disease among impoverished groups.

Understanding how SODHs affect your health will enable you to make better decisions for the future, thoroughly organize your steps, and live each day with an internal purpose (see diagram to look at how these factors affect your health).  Understanding that mental health is health and we must be conscious of when we aren’t “feeling right” and reach out to resources so that we are mentally healthy through life’s challenges.  Life can get hard as we strive to succeed. Failure happens.  Of course you’re allowed to fail! Anyone that tells you otherwise is simply bonkers! We all fail but some rebound more quickly, effectively, and thoroughly while others continue to spiral longer. No judgment. Everyone is walking their own path. Just stop judging yourself for failing and focus your efforts on picking up the pieces and moving forward. 

What Can I Do?

Some examples to help you get there: strive to manage money well.  Cut out frivolous spending  such as new clothes, nails, hair, car parts for the toy in the garage, and other things that stand in your way of managing money well. Another suggestion: eliminate alcohol in the home and no eating out at restaurants or take out for 100 days – either consistently or throughout a span of a year and each day the money that would be spent on those things, you get 100 envelopes and write the numbers 1-100 on the envelopes, pull one out each day and save the amount shown on the front and put it in the envelope.  By 100 days you will have $5,000!!  It’s up to you if you want to do this every day(for 100 days)  or throughout the span of a year, but before you know it, you will have saved a chunk to improve your living area or enroll your child into a special program that you have recently seen, or maybe even be able to do those therapy sessions you’ve been wanting to do.  In addition, using this method will help you save up for the hard times when you are barely able to pay the rent and short for the rest of the bills.  It is important to put priority in providing safe, stable, nurturing relationships and environments for ourselves and our children and preparing for hard times is a must if we want that to happen.

Now let me get off my soapbox for a minute : stabilize your relationships, your homes, your families.  Relationships are critical in determining health and quality of life.   According to research done by Van Niel C, Pachter LM and Wade R, Jr. , children in an abusive home are 12 times more likely to have attempted suicide, 7 times more likely to be alcoholic, and 10 times more likely to have injected street drugs” by the time they reach adulthood.  As parents, we must begin immediately to create nurturing, secure environments for our kids while motivating them to be the best version of themselves as they can be – while leading by example. Do you know what goes into being healthy and living your best life?  

What Goes Into Your Health?

This is an excellent diagram to show all the SDOHs affecting your health.  The first step is acknowledging how SDOHs affect your health and start making better decisions for the future, thoroughly organize your steps, and live each day with an internal purpose.  

Social Skills

Of course, I am here to help if you need help with making better decisions for the future and help with navigating through life.  Give me a call anytime. I would be honored to help you through your story! 



Semega, J., Kollar, M., Creamer, J., Mohanty, A. (2019). Income and Poverty in the United States. Retrieved from [PDF – 2.7 MB]

  1.  The National Health. Social Determinants- Factors that influence your health
  2. Semega, J., Kollar, M., Creamer, J., Mohanty, A. (2019). Income and Poverty in the United States. Retrieved from [PDF – 2.7 MB]
  3. National Center for Health Statistics, National Health Interview Survey, 2021
  4.  Centers for Disease Control and Prevention. (2018).  Social Determinants of Health: Know What Affects  Health. Retrieved from
  5. CEA report: Economic Perspectives on Incarceration and the Criminal Justice System
  6. Van Niel C, Pachter LM, Wade R, Jr, et al. Adverse events in children: predictors of adult physical and mental conditions. J Dev Behav Pediatr 2014;35:549–51. [PubMed] [Google Scholar]