What Are Social Determinants of Health?

What Are Social Determinants of Health? Everything That Stands in the Way

If you’ve worked in healthcare or public health, you’ve heard the term: Social Determinants of Health (SDoH). It’s become one of those phrases that’s repeated so often, it risks losing all meaning. But make no mistake—SDoH isn’t just a buzzword. It’s the truth behind why most people are sick.

So, let’s be clear:Social Determinants of Health are whatever obstacles a person faces at a point in time that limit their ability to be well. That includes access to food, safe housing, clean air, reliable income, transportation, education, and yes—even medical care.

In other words, SDoH is everything. And we ignore that reality at our peril.

The Old Model: Clinical Care as the Center of the Universe

For decades, we’ve funneled the lion’s share of our resources into clinical care. Hospitals, surgeries, medications, machines. We’ve built a $4.5 trillion healthcare system designed to treat disease—but not prevent it. We train providers to diagnose, prescribe, and bill. We pour funding into insurance mechanisms that pay for services after someone gets sick.

And what do we have to show for it?

• The highest per capita healthcare spending in the world.

• Life expectancy that trails behind peer nations.

• Exploding rates of chronic disease.

• A population where zip code predicts life expectancy better than genetic code.

The truth is harsh but inescapable: clinical care alone doesn’t create health.

SDoH: The Full Picture of a Person’s Health

Social Determinants of Health are the factors that surround us and shape our lives:

• Where we live. Is the neighborhood safe? Is there clean water? Are homes mold-free and heated?

• What we eat. Can we afford fresh food? Is a grocery store nearby or only gas stations?

• How we get around. Is there reliable transportation to a job or doctor’s office?

• Who supports us. Do we have someone to call in a crisis? Are we isolated or connected?

• What we earn. Does our paycheck cover rent and medications? Or do we have to choose?

• And yes—where and how we receive medical care. Because even the best doctor can't help someone who can’t get to an appointment or afford a prescription.

• THE MAIN POINT - SDOHS ARE WHATEVER EFFECTS AN INDIVIDUAL'S JOURNEY TO HEALTH AND WELLNESS AT ANY POINT, AND THEY EVOLVE OVER TIME.

  
  

In this light, social determinants aren’t adjacent to healthcare—they are healthcare.

Why This Matters Now More Than Ever

The gap between clinical investment and community need has never been wider. We spend billions on advanced treatments, while people can’t get clean water in rural towns. We install state-of-the-art imaging equipment in hospitals that are 60 miles from the people who need them. We develop digital health apps that assume everyone has Wi-Fi.

It’s time to flip the script.

A Call to Action: Shift the Investment

If we truly care about improving health—not just delivering care—we must stop treating community conditions as afterthoughts and start funding them like the lifesaving interventions they are. That means:

• Proactive engagement of individuals at high risk for poor health outcomes

• Investing in Community Health Workers who meet people where they are.

• Supporting housing-first models to reduce hospitalizations.

• Building food access infrastructure in underserved areas.

• Partnering with local organizations to tailor solutions to real barriers.

• And yes, realigning funding so that prevention is prioritized—not punished.

  
  

Conclusion: Social Determinants Are the Whole Story

Health is not what happens inside a clinic. It’s what happens in a person’s life—day in and day out. If a person is struggling with food insecurity, unstable housing, or other unknown SDOH, a prescription won’t fix it. A hospital bed won’t fix it. A discharge plan won’t fix it.

We don’t need more studies to prove this. We need more courage to act on what we already know: To improve health, we must invest in the conditions in which people live—not just the care they receive once they’ve fallen through the cracks. If we keep putting our money where the problem ends, instead of where it begins, we’ll keep getting exactly what we’re paying for: treatment without health.