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Social Determinants of Health

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What are Social Determinants of Health (SDOH)?

Our health is not just about what happens inside our bodies — the world around us and our life circumstances play a huge role in determining our physical health and quality of life. These non-medical factors are what we call the social determinants of health (SDOH): conditions in the environments where people are born, live and age that impact their overall well-being.

Why are they important?

Research shows that SDOH are often more important than healthcare or lifestyle choices. This means that in order to improve health, we need to address the wider forces that shape peoples’ lives, rather than just focusing on medicine and healthcare. Examples include: 

  • Discrimination
  • Drugs and alcohol
  • Education
  • Health literacy
  • Income
  • Job opportunities
  • Language skills
  • Literacy level
  • Neighborhoods
  • Nutritious foods
  • Physical Activity
  • Racism
  • Safe housing
  • Stress
  • Transportation

How big a role do SDOH really play?

Measuring the impact of SDOH is difficult because they all affect one another.

  • How much money a person makes often determines where they live. If the neighborhood they live in doesn’t have easy access to healthy food or is unsafe, that impacts health behaviors, such as eating a healthy diet or exercising.
  • Not being able to eat healthy food or exercise puts people at higher risk for many conditions, including heart disease, diabetes and high blood pressure. 

The impact of stress

Chronic stress leads to high levels of stress hormones, which can make you more likely to have diabetes, high blood pressure, heart disease, anxiety, depression, memory/concentration issues and more.

Access to quality health care

Access to quality health care goes beyond being able to afford treatment. It also means having access to preventive care that may stop a person from becoming sick in the first place, catching diseases in early stages before irreversible damage is done and comprehensive care that also includes services for mental health, social work, nutrition and more.


A person’s neighborhood and living situation have major impacts on their health. Examples of exposures that can have direct impacts on health include:

  • High rates of violence
  • Unsafe water (e.g., high levels of lead or pollution)
  • Polluted air
  • Second-hand smoke
  • Loud noises

Exposures, such as these, may also limit a person’s ability to spend time outdoors and increase baseline stress.

Social and community context

Interactions with family, friends, co- workers and community members have many impacts on a person’s health.

  • Feeling safe in your home and having consistent, loving care is important for all aspects and stages of development.
  • Social connections help alleviate stress by providing a network of support.

Access to quality education

Education affects health at every stage of life.

  • EARLY LIFE: Education impacts children’s brain development, setting them up for success in future education and employment.
  • ADOLESCENCE: Quality education makes teens more likely to stay in school, which decreases the likelihood of drug or alcohol use.
  • ADULTHOOD: Education gives people the tools they need to make informed decisions about their own health, from healthy lifestyle choices to having the information to make shared decisions with providers.

Economic stability

  • Working multiple jobs, having a long commute or not having childcare means many people who lack economic stability often don’t have time to make “healthy choices,” such as cooking healthy meals at home or exercising.
  • Economic stability means more than being able to provide necessities like food, clean water and clothing — it also means safe, stable housing, being able to afford healthcare and many other things that impact health.

This is a very brief overview of a few SDOH and why they are so important to health and healing.

There are many things beyond our control, but others we may be able to change. We hope that this will help empower patients and families to view taking an active role in modifying some of their own social determinants as a part of their health journey. Finding support, resources and help when needed can make a big difference. If you want to learn more about other resources or ones more specific to your needs, Trauma Survivors Network coordinators, social work and case management are here to help.

Some resources for you to explore:

  • NC 211 is an information and referral service. Families and individuals can dial 2-1-1 or go to nc211.org to obtain free and confidential information on health and human services and resources within their community.
  • NCWORKS: Helps people find work, gain job skills and prepare for interviews. 919-250-3770
  • Career Connections Centers: Helps people find work, gain job skills and prepare for interviews. Offers career guidance, job placement and help with job searches and resumes. 336-236- 8021
  • Division of Employment Security: Offers unemployment insurance benefits for people who lost their jobs through no fault of their own. 888-737-0259
  • El Centro Hispano Community Engagement and Advocacy Program: Offers programs teaching leadership development, community development and community advocacy. 984-208-2158
  • East Wake Education Foundation: Activities to help parent and child interactions, daily preschool that teaches advanced skills useful in kindergarten. 919-366-5901
  • Elimu Empowerment Services: Offers tutoring and mentoring programs for youth. 336-988-8108
  • East Coast Migrant Head Start Project: A preschool education program to help children prepare for school success. Offers health and mental health services. Also offers parenting education, nutrition education and services for children with disabilities. Various locations throughout the state. 919-420-0334
  • Fair Housing Project: Offers education, outreach and advocacy to end housing discrimination and to ensure equal housing opportunity for all. Also helps tenants with disabilities with housing issues. 866-219-5262
  • Housing Counseling Services: Offers counseling on purchasing, mortgage delinquency, reverse mortgages and renting. Also offers workshops on homebuyer education and foreclosure prevention. 877-322-8824
  • Raleigh Rescue Mission: non-profit dedicated to serving those experiencing homelessness in our community through the love of Christ. Resources and services available include meals, clothing, hygiene and healthcare to providing counseling, parenting classes, resources for children’s care, transportation and vocational and career training. 919-828-9014
  • Advance Community Health Clinic: Offers primary care services, screenings (high blood pressure, diabetes, hearing/ vision and more), general physical examinations, lab work, immunizations and care for acute conditions like an ear infection or sore throat. 919-833-3111