Key social determinants of health

Abstract

1. Health is profoundly affected by certain conditions commonly referred to as the “social determinants of health”.1, 2 These factors relate to the physical, social and economic environments in which people live, and they affect health by impacting on peoples’ living circumstances and quality of life. These conditions include income or wealth and its distribution, early childhood care, education, employment and working conditions, unemployment and employment security, food security, health-care services, housing, social exclusion, culture, religion, and social safety nets. 2. There is now ample evidence that policy, action and leadership to address the key social determinants can improve health.3 Investments in the basic social determinants of health will profoundly improve the health of populations most exposed to health-threatening conditions; these populations include the poor, the marginalized, and those people excluded from participation in certain aspects of society because of their living conditions. Some countries (such as Costa Rica, Cuba and Sri Lanka) have made concerted efforts to address the social determinants of health, and they have achieved high levels of health status despite their low income status.4