4.3 trillion dollars. That number, as of 2021, is how much the United States spends on healthcare each year. With approximately 331 million people in the U.S., that number translates to roughly $12,900 per person. And yet, several factors limit access to healthcare for some individuals more than others, resulting in a system lacking equity. These factors are the Social Determinants of Health. 

According to a report released by the Assistant Secretary for Planning and Education (ASPE) Office of Health Policy in April of 2022, the social determinants of health affect roughly 50% of the variation in health outcomes between people living in the United States. According to the Department of Health and Human Services, “Healthy People 2030” program, the determinants can be broken down into 5 key categories: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social community context. These can be further broken down into individual circumstances. Detriment in neighborhood and built environment, for example, could present itself as a community without access to a grocery store. Those living in said community would by extension, have poorer nutritional health, and poorer health outcomes. Often, the Social Determinants of Health force people to remain in a perpetual and generational cycle of poverty and exclusion that is nearly impossible to escape. For example, if faced with poorer nutrition, an individual is more likely to end up sick or in a hospital. As such, they would be less likely to spend time in the workplace, resulting in less pay, and less money to spend on fresh produce in the future. The cycle continues. 

Additionally, certain communities are more likely to be affected by the Social Determinants of Health than others. In an article published in 2017, researchers tracked data from 1935 to 2016 and identified key factors that resulted in a greater impact of determinants. These include race/ethnicity, education, poverty, and geographic location, amongst others. Historically, while poverty rates are decreasing across various races, minorities are still disproportionately more likely to experience poverty than others. Data collected by the United States Census Bureau in 2019 found that 18.8% of Black people and 15.7% of Hispanic people are in poverty, whereas 7.3% of White people are in poverty. These rates affect not only the ability of an individual to pay for healthcare but also the other factors that compound to decrease accessibility even further. For example, in many cases, when faced with poverty, education takes less of a priority, with an emphasis placed on entering the workforce sooner and contributing to the family income. A lack of education and educational opportunities for the next generation results in the aforementioned cycle of generational poverty and generational impacts of the Social Determinants of Health. 

The article released by the ASPE Office of Health Policy in April of 2022 discusses key measures that would decrease the impact of the Social Determinants of Health on populations negatively affected. These include but are not limited to, housing and nutrition initiatives, access to transportation to escape geographical barriers to healthcare, connections with social services, and social and economic mobility in the form of financial assistance. Addressing the Social Determinants of Health is no easy feat, yet understanding the upstream causes and downstream results is vital to progress. Identifying the root causes of the issue, rather than placing a bandaid on the effects will ensure a brighter future for the next generation of families currently impacted. 

To learn more about the Social Determinants of Health, visit https://health.gov/healthypeople.