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Social Determinants

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A range of personal, social, economic, and environmental factors contribute to individual and population health. For example, people with a quality education, stable employment, safe homes and neighborhoods, and access to preventive services tend to be healthier throughout their lives.1 Conversely, poor health outcomes are often made worse by the interaction between individuals and their social and physical environment.

Social determinants are in part responsible for the unequal and avoidable differences in health status within and between communities. The selection of Social Determinants as a Leading Health Topic recognizes the critical role of home, school, workplace, neighborhood, and community in improving health.


The Social Determinants Leading Health Indicator is:


Although education is the Leading Health Indicator for this topic, many of the Healthy People 2020 objectives address social determinants as a means to improve population health.

Health Impact of Social Determinants

Social and physical determinants affect a wide range of health, functioning, and quality of life outcomes. For example:

  • Access to parks and safe sidewalks for walking is associated with physical activity in adults.2
  • Education is associated with:
    • Longer life expectancy
    • Improved health and quality of life
    • Health-promoting behaviors like getting regular physical activity, not smoking, and going for routine checkups and recommended screenings.3
  • Discrimination, stigma, or unfair treatment in the workplace can have a profound impact on health; discrimination can increase blood pressure, heart rate, and stress, as well as undermine self-esteem and self-efficacy.3
  • Family and community rejection, including bullying, of lesbian, gay, bisexual, and transgender youth can have serious and long-term health impacts including depression, use of illegal drugs, and suicidal behavior.4
  • Places where people live and eat affect their diet. More than 23 million people, including 6.5 million children, live in “food deserts”—neighborhoods that lack access to stores where affordable, healthy food is readily available (such as full-service supermarkets and grocery stores).5

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