Social determinants of health: what the term means and why it matters

When people think of what keeps us healthy, they usually think of doctors and hospitals. Public-health researchers point out that much of what shapes health happens elsewhere. The World Health Organization describes the social determinants of health as the non-medical factors that influence health outcomes: the conditions in which people are born, grow, work, live and age, and the wider forces and systems that shape those conditions.

These include income and social protection, education, employment, housing and neighbourhood, food security, access to services, and discrimination. Differences in these, when they are unfair and avoidable, are described as health inequities, a term that implies they could be addressed.

Why it matters: a health system can treat illness, but it cannot, on its own, fix poor housing or insecure work. Policies in other areas therefore have health effects, whether or not that is their aim.

Limits: the evidence on which interventions work best is still developing, and causes are tangled, so effects of any one factor are hard to isolate.

When someone says "health is a political issue", this concept is often what they mean.