Unveiling the Impact: Social Determinants of Health Explored
Have you ever considered all the things that impact your overall well-being? It turns out there are many different factors that impact health outcomes. These are called "Social Determinants of Health” or “the SDOH”.
The SDOH are the conditions in which you are born, grow up, live, work, and age, and most are beyond your control. They also make up almost 50% of the overall factors that contribute to your health, meaning that the SDOH is a testament to health and wellness being so much more than just diet and exercise. So it is important that you acknowledge your unique set and use a critical lens to view the lucrative messaging diet culture is selling - namely that your body weight and size are the primary determinants of your health.
Armed with this newer and broader information, ask yourself - is this true? What else is true? And what about the other half of the determinants that you do have influence over? Can you root your efforts in care and make internally driven choices based on how you feel and what you need? Focus on daily do-ables and sustainable behaviors that make you feel your best and connect you to you?
Find HAES-aligned providers and professionals like the Registered Dietitians at CV Wellbeing who can offer support and help you set meaningful intentions around your health that are uniquely yours and aligned with your values. Let’s keep all of this in mind as we continue to unpack what the SODH is and what this means to you.
Some Evidence-based Examples of Social Determinants of Health
Access to quality education. The more education you have, the more likely you are to make health-promoting choices, avoid tobacco and alcohol, and care for yourself overall. Plus, education can lead to better job opportunities, higher incomes, and access to premium health insurance and healthcare services, all of which can lead to better health outcomes.
Economic stability. Health can be seriously impacted when struggling to make ends meet or not having access to basic needs like food and shelter. Financial stress can also lead to mental health concerns like anxiety and depression, increasing the risk of chronic disease (CDC). On the other hand, economic stability often contributes to social connection and a sense of community, positively impacting mental and physical health.
Food access. If you don't have enough food or access to quality food, you're at higher risk for things like nutrient deficiencies and chronic disease. Food deserts make it hard for people to find a wide variety of foods, let alone foods they actually enjoy and feel nourished by.
The environment. Air pollution, unsafe drinking water, and poor housing conditions can all contribute to negative health outcomes ranging from respiratory disease and heart disease to diarrhea and hepatitis A. On the flip side, access to green spaces like parks and forests can reduce anxiety and depression. And being around all that green space and landscaped bike lanes and paths can inspire us to get moving and be more active in our day-to-day.
Social support. Social support is essential to promoting well-being; a lack of social support can lead to an increased risk of mental health disorders, high blood pressure, inflammation, and other risk factors associated with cardiovascular disease. Moreover, the effects of social isolation on mortality rates have been well-documented, and those who are socially isolated have a higher risk of premature death.
Lack of access to quality and inclusive healthcare. Healthcare access can have a major effect on health if it prevents you from getting treatment when you need it. Furthermore, non-inclusive and stigmatizing healthcare practices can create fear and mistrust of the healthcare system among marginalized communities. This can lead to individuals avoiding seeking medical help or not receiving necessary preventive care, ultimately resulting in poorer health outcomes. Language and cultural barriers can act as significant obstacles to accessing healthcare, particularly for those from non-English speaking backgrounds. This can make navigating the healthcare system and receiving appropriate care difficult, leading to significant disparities.
Discrimination. Discrimination can create chronic stress, leading to long-term physical and mental health problems, such as high blood pressure, heart disease, and depression caused by higher rates of stress hormones and inflammation, contributing to a range of health problems. Racism and discrimination can also contribute to higher rates of anxiety, depression, and post-traumatic stress disorder (PTSD).
Trauma. People who have experienced trauma and/or have post-traumatic stress disorder (PTSD) have higher rates of stress hormones and inflammation, which can contribute to various physical and mental health concerns. Trauma can also impact behavior, leading to increased risk-taking behaviors, which can negatively impact health.
How does Diet Culture Impact our view of Health?
Instead of recognizing the SDOH, diet culture places the burden of improving our health solely on us alone, even if some aspects are beyond our control. Foods are labeled as good or bad (hint*: nutrition isn't that simple), disregarding accessibility issues some folks might have, leaving them feeling shame and guilt when the "bad" foods are the only foods they can afford. This approach is extremely harmful and can lead to shame and guilt for not being able to afford or access the "right" foods.
Furthermore, diet culture promotes a narrow, Eurocentric view of what constitutes "healthy" food, disregarding culturally rich and significant foods that may be more accessible or meaningful to different communities. This not only denies people of enjoying foods they find comforting and meaningful but also perpetuates issues of racism and classism, which can harm our relationship with our community and lead to negative health outcomes.
Diet culture demands time and money to live up to its standards of "health". This image is only attainable for a very small number of people with adequate time, access to resources, and financial means. Failing to achieve this image of a standard for "health" can create fear, shame, and guilt when folks ultimately cannot meet it. When the small select group of people who have obtained diet culture's picture of "health" advertises their success, they often say things such as, “If I can do it, you can too!". In reality, their "success" is often driven by factors largely out of our control, such as genetics and adequate resources. The reality is that the factors that contribute to our health go beyond personal responsibility and include systemic issues that are not often talked about.
How the Social Determinants of Health and Intuitive Eating Intersect
Intuitive eating can be a useful tool for some facing SDOH that negatively impacts their food choices. For example, having limited access to fresh produce can make it difficult to follow traditional ways of eating produce. Intuitive eating, however, encourages individuals to focus on eating what is available and satisfying without the added stress of trying to follow a diet.
I want to acknowledge that practicing intuitive eating is a privilege that is not accessible to everyone. The difficulties posed by food insecurity, limited food options, and economic constraints can all present significant challenges when it comes to listening to our bodies and eating intuitively. Additionally, embracing intuitive eating requires a certain amount of mental space and effort, which may be in short supply for those struggling to meet their basic survival needs on a daily basis. It's perfectly alright if nutrition isn't currently at the forefront of your mind. That being said, this is precisely why collaborating with a registered dietitian can be immensely valuable. They can offer personalized solutions tailored to your unique circumstances and assist you in making the most of what you have available.
It's also important to note that while intuitive eating can be helpful for some individuals dealing with stressors related to SDOH, it is not a solution to these larger systemic issues. Advocating for policies that address SDOH, such as increasing access to healthy food options and affordable housing, is crucial for creating lasting change.
The SDOH is ultimately a list of reasons why we should not blame ourselves for being unable to conform to the narrow ideal of health promoted by diet culture. By examining the various factors contributing to our health, we can gain a broader perspective. Then, we have room for meaningful choices that honor the set of social conditions in which you live and also support you in all the empowered ways you can positively affect your health.
For those who may be learning about SDOH for the first time, I hope that this knowledge can foster a greater sense of empathy and kindness toward oneself and others in matters of health while setting the scene for you to acknowledge your limitations AND strive to positively influence all the things you can to improve your health and well-being. The system may be wrought with challenges, but you can still achieve personal well-being. Reach out to the team at CV Wellbeing at any time for guidance and support - we promise to meet you where you are at!