Social Determinants of Health in the US


Compared to the developing nations the overall health status of the American population is much better. However, when compared to other developed countries, the United States ranks rather poorly. Effects of social determinants of health have been blamed for this situation.

Social determinants of health define how the social environment which one grew up and is living in effects the health of the person. As such, different socio-economic groups have different degrees of health as seen in the occurrence, frequency and severity of certain disease; in the long run, it determines the quality of life and the life expectancy.

The following are social determinants of health;

  • Employment or unemployment, security of employment or unemployment, and the working conditions
  • Early life, gender, social exclusion and social safety net
  • Income and its distribution
  • Food security and housing
  • Education
  • Healthcare services
  • Aboriginal status

Variations to these determinants for different individuals alter the health of a person either for the better or for the worse. As such, persons who are genetically identical, such as identical twins, will have different levels of health of they grew up in different environments.

Income and Its Distribution

This determinant may singularly have the most profound effect on the health of an individual. In this case, we will consider even the effects of income of parents on the health of their offspring. The level of income determines many things; these include the diet, transport, level and quality of education; diet; quality of housing among other issues.

Low income puts a person in direct risk of developing some of the disease that if a higher income situation; living under condition of material depravation in childhood and/or in as an adult has issues of stress; this in turn results in a higher likelihood of engaging in risky behavior such as alcohol and tobacco consumption as a means of coping with the unfavorable condition. As such, living in childhood condition that was deprived is a better predictor of the occurrence of heart disease, stroke and diabetes type-II than the risk factors that are traditionally associated with the occurrence of this disease (Baker et al, 1989; Davey-Smith et al, 2002; Eriksson et al, 1999).

Studies have shown that children who grew up in an environment where their parents earned less than ideal amounts of money have a greater incidence of a number of conditions that tend to affect people of that age; these include infectious diseases and physical injuries. Additionally, they are prone to other issues such as child abuse and poor advancement in education (CICH, 2000).

Changing the Situation

While social disparity in income has been there since the first civilization, the widening health gap that this disparity has created is a recent development. The key to solving the issue is making sure that such disparity does not affect the health of the population; such would require the country to take a proactive approach towards provision of health services to persons of all social classes. Additionally, a mitigation of the adverse conditions that low income creates so that they have a smaller effect on health is necessary.

The United States in particular has been noted to have a laissez-faire attitude towards provision of social amenities such as proper housing and healthcare compared to particularly the Scandinavian countries which go to great lengths to ensure that its citizen’s health is not affected by low or lack of income (Bambra, 2004; Navaro and Shi, 2002).


Countries, such as the United States, which have demonstrated lower commitment to reducing the effects of income on health than its counterparts in Western Europe, have poorer indicators of the general health of the population (Raphael, 2007).


  1. Bambra, C. (2004). The worlds of welfare: illusory and gender blind? Social Policy and Society, 3(3), 201-211.
  2. Barker, D. J., Osmond, C., and Simmonds, M. (1989). Weight in infancy and death from ischemic heart disease. The Lancet, 2, 577-580.
  3. Canadian Institute on Children’s Health. (2000). The Health of Canada’s Children: A CICH Profile 3rd Edition. Ottawa, Canada: Canadian Institute on Children’s Health.
  4. Davey-Smith, G., and Hart, C. (2002). Life-Course Approaches to Socio-Economic and Behavioural Influences on Cardiovascular Disease Mortality. American Journal of Public Health, 92(8), 1295-1298.
  5. Eriksson, J., Forsen, T., Tuomilehto, J., Winter, P., Osmond, C., and Barker, D. (1999). Catch-up growth in childhood and death from coronary heart disease: longitudinal study. BMJ – Clinical Research, 318(7181), 427-431.
  6. Navarro V. and Shi L. (2002). The political context of social inequalities and health. In V. Navarro (Ed.), The Political Economy of Social Inequalities: Consequences for Health and Quality of Life (pp. 403-418). Amityville, NY: Baywood.
  7. Raphael, D. (2007). Poverty and Health. In D. Raphael (Ed.), Poverty and Policy in Canada: Implications for Health and Quality of Life (pp. 205-238). Toronto: Canadian Scholars’ Press.
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