Social Determinants of Health

How can our social circumstances affect our Health?

Social Determinants of Health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries. [1]

Another definition, one that brings us closer to the daily impacts, states: “the social determinants of health are the economic and social conditions that influence the health of individuals, communities and jurisdictions as a whole. They determine the extent to which a person possesses the physical, social, and personal resources to identify and achieve personal aspirations, satisfy needs, and cope with the environment. The resources include but are not limited to conditions for early childhood development; education, employment, and work; food security, health services, housing, income, and income distribution; social exclusion; the social safety net; and unemployment and job security.2 

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I diagnosed “abdominal pain” when the real problem was hunger, I confused social issues with medical problems in other patients’, too. I mislabeled the hopelessness of long-term unemployment as depression and the poverty that causes patients to miss pills or appointments as noncompliance. In one older patient, I mistook the inability to read for dementia. My medical training had not prepared me for this ambush of social circumstance. Real-life obstacles had an enormous impact on my patients’ lives, but because I had neither the skills nor the resources for treating them, I ignored the social context of disease altogether.

 Laura Gottlieb, MD



Put patient Poverty on your radar: BC Poverty Screening Tool

Look for more information about this tool here at the Kootenay Boundary Division of Family Practice Webpage








[1] WHO Commission on Social Determinants of Health;; retrieved December 13, 2010.

[2] Raphael Dennis (Ed) 2004. Social Determinants of Health: Canadian Perspective


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