How do social determinants of health impact health outcomes?

There are many studies that show that social determinants of health (SDOH) impact health outcomes. A more challenging question is how do SDOH impact health outcomes? Specifically, through what pathways or mechanisms do SDOH operate?

A paper by Thimm-Kaiser (2023) identifies 8 mechanisms through which SDOH impact outcomes. These include:

  • SDOH are underlying causes of health inequities
  • SDOH shape health inequities through contextual influences
  • SDOH contextual disadvantage is not deterministic
  • SDOH shape health over the life course
  • SDOH operate through biological embedding
  • SDOH operate intergenerationally
  • SDOH shape clustering and synergies of health inequities
  • Unjust social processes shape SDOH mechanisms to produce health inequities

While these points are helpful, more useful are the graphical examples the article provides showing how SDOH impacts outcomes across these 8 pathways. These are pasted below.

You can read the full article here.