Social Determinants of Health (SDOH)

  • With respect to oral health, there is burgeoning evidence that health insurance inequalities, cultural norms, income, limited access to healthy foods, unemployment, and transportation are among the social determinants that have a particular impact on access to oral health care and care-seeking behaviors…Patrick, D. L., Lee, R. S. Y., Nucci, M., Grembowski, D., Jolles, C. Z., & Milgrom, P. (2006). Reducing oral health disparities: a focus on social and cultural determinants. BMC Oral Health, 6(1), S4.
  • Given the interconnectedness of oral and overall health (e.g., dental disease is a risk factor for cardiovascular disease, diabetes, and respiratory problems), strategies to address social determinants related to physical health can be adapted to address oral healthK. Brennan Ramirez, E.A. Baker, and M. Metzler. Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. Available at: http://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/pdf/SDOH-workbook.pdf.
  • Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks[i]. Research has shown that these factors can have a profound impact on health access and outcomes, including oral health.[ii] The effectiveness of strategies to address social determinants of health and improve health outcomes, which are well-documented in the literature, suggest an opportunity to identify and address social determinants of oral health (SDOH), specifically…. A Community Framework for Addressing Social Determinants … chcs.org/media/SDOH-OH-TA-Brief_012517.pdf
  • A significant impact on their overall health outcomes, including oral health. These social flourishing body of research illustrates that the way individuals live, learn, work, and play has determinants of health (SDOH) — including water and air quality; access to healthy food; housing; employment; access to health care; cultural norms; available transportation; and education — are wide and varied in communities across the country… Office of Disease Prevention and Health Promotion (2016). “Understanding Social Determinants of Health.” Available at: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health .

 

  • Along with an individual’s biological characteristics, the SDOH can shape risk behaviors, environmental exposures, and access to health care… F Schwendicke, CE Dorfer, P Shlattman, L Foster Page, W Thomson, S Paris (2015). “Socioeconomic Inequality and Caries: A Systemic Review and Meta-Analysis” Journal of Dental Research.” Available at: http://jdr.sagepub.com/content/94/1/10.full.pdf+html
  • Social factors most persistently affect those marginalized due to socioeconomic status, race and ethnicity, disability status, geographic location, or some combination of these… K. Brennan Ramirez, E.A. Baker, and M. Metzler. Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. Available at: http://www.cdc.gov/nccdphp/dch/programs/healthycommunitiesprogram/tools/pdf/SDOH-workbook.pdf.
  • It is estimated that differences in social conditions account for more than one third of total annual deaths in the United States… A. Schroeder. “We Can Do Better — Improving the Health of the American People.” New England Journal of Medicine, 2007, 357:1221-8… L. Taylor, A. Hyatt, and M. Sandel. “Defining the Health Care System’s Role in Addressing Social Determinants and Population Health.” Health Affairs Blog, Nov. 17, 2016. Available at: http://healthaffairs.org/blog/2016/11/17/defining-the-health-care-systems-role-in-addressing-socialdeterminants-and-population-health/

 

  • Over the past several decades, approaches to reducing health disparities have evolved from traditional clinical interventions to reflect the importance of healthy behaviors or “lifestyle,” and more recently to recognize the role that social determinants in the community also play… Taylor, A. Hyatt, and M. Sandel. “Defining the Health Care System’s Role in Addressing Social Determinants and Population Health.” Health Affairs Blog, Nov. 17, 2016. Available at: http://healthaffairs.org/blog/2016/11/17/defining-the-health-care-systems-role-in-addressing-socialdeterminants-and-population-health/.
  • There is also a growing focus on addressing SDOH through cross-sector partnerships that may engage a range of health care systems and community-based organizations such as housing authorities, nutrition support programs, and others… Patrick and Less, et al., op cit.
  • With respect to oral health, there is burgeoning evidence that health insurance inequalities, cultural norms, income, limited access to healthy foods, unemployment, and transportation are among the social determinants that have a particular impact on access to oral health care and care-seeking behaviors… Institute of Medicine and National Research Council. Improving Access to Oral Health Care for Vulnerable and Underserved Populations. Washington, DC: The National Academies Press, 2011.

[i] Office of Disease Prevention and Health Promotion (2016). “Understanding Social Determinants of Health.” Available at: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health .

[ii] F Schwendicke, CE Dorfer, P Shlattman, L Foster Page, W Thomson, S Paris (2015). “Socioeconomic Inequality and Caries: A Systemic Review and Meta-Analysis” Journal of Dental Research.” Available at: http://jdr.sagepub.com/content/94/1/10.full.pdf+html