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Inadequate health insurance coverage is one of the largest barriers to health care access, and the unequal distribution of coverage contributes to disparities in health. Out-of-pocket medical care costs may lead individuals to delay or forgo needed care (such as doctor visits, dental care, and medications), and medical debt is common among both insured and uninsured individuals.

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Graduation from college has a positive impact on employment options. Higher education helps people secure better-paying jobs with fewer safety hazards. Income from these employment opportunities may improve health by increasing people’s ability to accrue material resources, such as higher-quality housing, as well as psychosocial resources, such as higher social status.

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Topics that apply to all categories of SDOH

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Topics that apply to all categories of SDOH

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High levels of social support can positively influence health outcomes through behavioral and psychological pathways. For example, social support may help people stick to healthier diets and reduce emotional stress. Both of these pathways can affect biological functioning in the cardiovascular, neuroendocrine, and immune systems.

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Discrimination is a socially structured action that is unfair or unjustified and harms individuals and groups. Discrimination can be attributed to social interactions that occur to protect more powerful and privileged groups at the detriment of other groups.

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Lack of health insurance decreases the use of preventive and primary care services and is associated with poor health outcomes. Individuals without health insurance may delay seeking care when they are ill or injured, and they are more likely to be hospitalized for chronic conditions such as diabetes or hypertension.

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Limited literacy is a barrier to health knowledge access, proper medication use, and utilization of preventive services. Individuals with limited literacy face additional difficulties following with medication instructions, communicating with health care providers, and attaining health information—all of which may adversely affect their health.

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Residents of impoverished neighborhoods or communities are at increased risk for mental illness, chronic disease, higher mortality, and lower life expectancy.

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Crime and violence experienced by individuals living in a community is an important public health issue. Violence can lead to premature death or cause non-fatal injuries. People who survive violent crime endure physical pain and suffering and may also experience mental distress and reduced quality of life.

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Access to Foods that Support Healthy Eating Patterns

Crime and Violence

Environmental Conditions

Quality of Housing

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Access to Health Care

Access to Primary Care

Health Literacy

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Civic Participation

Discrimination

Incarceration

Social Cohesion

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Early Childhood Education and Development

Enrollment in Higher Education

High School Graduation

Language and Literacy

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Employment

Food Insecurity

Housing Instability

Poverty