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The Social Determinants of Health: Coming of Age
Open accessAbstract
In the United States, awareness is increasing that medical care alone cannot adequately improve health overall or reduce health disparities without also addressing where and how people live. A critical mass of relevant knowledge has accumulated, documenting associations, exploring pathways and biological mechanisms, and providing a previously unavailable scientific foundation for appreciating the role of social factors in health. We review current knowledge about health effects of social (including economic) factors, knowledge gaps, and research priorities, focusing on upstream social determinants—including economic resources, education, and racial discrimination—that fundamentally shape the downstream determinants, such as behaviors, targeted by most interventions. Research priorities include measuring social factors better, monitoring social factors and health relative to policies, examining health effects of social factors across lifetimes and generations, incrementally elucidating pathways through knowledge linkage, testing multidimensional interventions, and addressing political will as a key barrier to translating knowledge into action.
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“Conversely, low academic achievement is strongly associated with risk-taking behavior, compromised health status, and reduced longevity.22–33”
From School-Based Health Centers to Advance Health Equity (2016) · cites this paper as [23]
Experimental — accuracy not yet measuredIn the citing paper
“However, these approaches are not sufficient to address social determinants such as neighborhood conditions or poverty, which are also fundamental drivers of persistent health disparities.3, 8”
From Evaluating strategies for reducing health disparities by addressing the social determinants of health. (2016) · cites this paper as [3]
In the citing paper
“For example, if one’s neighborhood is unsafe even during daylight hours and an individual lacks the resources to move to a safer neighborhood, interventions targeting outdoor physical activity are unlikely to be effective.3”
From Evaluating strategies for reducing health disparities by addressing the social determinants of health. (2016) · cites this paper as [3]
In the citing paper
“As such, there is a growing consensus that adopting a life course perspective, meaning focusing on how experiences early in life can impact health over a lifetime and even across generations, is one of the most important strategies to improve the nation’s health and is critical to reducing and eliminating population-level health disparities.3, 11”
From Evaluating strategies for reducing health disparities by addressing the social determinants of health. (2016) · cites this paper as [3]
In the citing paper
“Social determinants that negatively impact health and wellbeing include poverty; lack of access to quality education or employment; unhealthy housing; unfavorable work and neighborhood conditions; exposure to neighborhood violence; and the clustering of disadvantage in particular groups of people and in particular places.3”
From Evaluating strategies for reducing health disparities by addressing the social determinants of health. (2016) · cites this paper as [3]
In the citing paper
“External constraints that may prevent health-promoting activities include poor housing, poor working conditions, and poverty [24].”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [24]
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Metadata
- Authors
- Braveman, P., Egerter, S., & Williams, D. R.
- Affiliations
- University of California, San Francisco (US)
- Harvard University (US)
- Venue
- Annual Review of Public Health
- Publisher
- Annual Reviews
- Published
- 2011-04-21
- Volume
- 32
- Issue
- 1
- Pages
- 381-398
- ISSN
- 0163-7525 (ISSN-L)
- 1545-2093
- OpenAlex
- W2164184454
- Cited by
- 2,476
- References
- 115
- Citations by year
- 2026: 218 · 2025: 273 · 2024: 290 · 2023: 224 · 2022: 217 · 2021: 268 · 2020: 213 · 2019: 150 · 2018: 115 · 2017: 114 · 2016: 113 · 2015: 109 · 2014: 71 · 2013: 53 · 2012: 35
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Public Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
- Keywords
- social determinants of health, health disparities, economic resources, racial discrimination, multidimensional intervention, health policy, research priorities, knowledge translation, political will
- MeSH terms
- Health Policy, Humans, Politics, Public Health, Socioeconomic Factors, United States, Health Status Disparities, Healthcare Disparities
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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