Research, Statistics, Writing, Dissertation & Publishing

The SDH have an important influence on health inequities - the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.

The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:

Income and social protection
Education
Unemployment and job insecurity
Working life conditions
Food insecurity
Housing, basic amenities and the environment
Early childhood development
Social inclusion and non-discrimination
Structural conflict
Access to affordable health services of decent quality.
Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health. For example, numerous studies suggest that SDH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.

Addressing SDH appropriately is fundamental for improving health and reducing longstanding inequities in health, which requires action by all sectors and civil society.

Inequalities in the social determinants of health have been unmasked by the COVID-19 pandemic, and have led to glaring inequities in COVID-19 health outcomes
between population groups, partly mediated through differences in capacity to adhere to public health and social measures that reduce viral transmission (such as
handwashing, use of face-masks, physical distancing, and closure of workplace, schools and public events). In turn, the broader impacts of the COVID-19 pandemic
have unequally impacted on the social determinants of health themselves, further exacerbating health inequities. These unacceptable and unjust outcomes
highlight the need to take greater account of social determinants of health in pandemic preparedness and response efforts, including for the rest of the current COVID-19 pandemic.

AHRQ is reporting on healthcare quality and disparities. The annual National Healthcare Quality and Disparities Report is mandated by Congress to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeconomic groups. The report is produced with the help of an Interagency Work Group led by AHRQ.