In conversations involving the factors affecting health, we constantly hear medications, exercise, and habits, all of which are manageable by the person in question.
However, there are other social factors, not controllable by the patient, which can affect their health. These social factors are known as the Social Determinants of Health. They are very important because they highlight the fact that one's environment can be detrimental to their health and it is not always something that can easily be changed.
1. Income and social status
One's income and social status can affect a person's access to healthcare. Consider Person A and Person B.
Person A is a person with higher income than Person B. Assuming both have access to health insurance (HMO is more affordable than PPO), Person A will have access to greater coverage, flexibility in the doctors they choose, and in some cases, a deductible. Person B, in the meantime, will afford HMO where they get less coverage and flexibility in their choice of doctors.
Again, this is assuming Person B has access to health insurance whereas if they didn't, they'd be facing a myriad of risks. Not to mention the financial and emotional stress they'd face if they'd be forced to go to the emergency room where the bill would be very expensive.
2. Social support networks
Greater support from the people around you is linked to better health. While two-parent families have a steady income coming from one parent or the other, the financial burden, and the related stress, doesn't fall solely on one person. They share the stress with each other and have someone to lean on when times get rough.
In single-parent households, however, the burden and stress falls onto the one parent, giving them more to worry about. They may not have family to lean on in times of trouble, and their health may be affected by the stress.
3. Education and literacy
Lower education levels are linked with poor health and more stress. Because those with lower education tend to have jobs with lower pay, the stress of their financial burdens can lead to stress on their bodies. Along with several other factors, stress can lead to hypertension, which in turn can lead to a stroke. While those with higher paying jobs face stress without a doubt, the burden of living paycheck to paycheck is not a problem, reducing the stress exponentially.
4. Employment/working conditions
One word: factories. People who work in factories are exposed to many chemicals that can have a negative effect on their bodies. They then go home and take the lingering chemicals on their clothes into their homes, affecting their families as well.
Moreover, having access to sick time, parental leave, paid sick leave, and health insurance through a company can influence one's health as well. It doesn't matter how many medications one is taking, if they are not getting the proper rest necessary to allow the body to fight whatever illness they have, the body is going to lose every time.
5. Social environments
The social environment one is can affect their health in the least expected ways. Although doctors make an oath to treat all patients the same, there will always be prejudices in place. Sometimes, without realizing, doctors may treat patients of different races differently.
Although it is difficult to admit, the country was founded on racism, our generations have been raised in racism, it is therefore only possible for the country to still have acts of racism. Racism affects the health of our people in various ways, in the hospital only being one of them.
6. Physical Environments
Clean air and water, safe household structures, and communities can all affect a person's health. The water children drink will affect their developing bodies as well as the immune systems of their families. The air can affect the lungs of those in the area.
Factories, for example, can be a burden on people's health and they don't even realize it. The material houses are made of can affect people's health. For example, older houses can have lead paint, asbestos, or carbon monoxide, and these are all very dangerous for people to be breathing in, especially on a daily basis.
7. Personal health practices and coping skills
One's coping mechanisms and daily behaviors can affect their health more than we realize. Having a balanced diet, regularly exercising, taking their medications as instructed can all positively affect a person's health. Smoking, drinking, binge eating, and having unhealthy psychological coping skills can negatively affect a person's health. Lung disease, anxiety, obesity, and diabetes are only a few of the consequences of bad habits and coping skills.
8. Healthy child development
An unhealthy childhood can lead to an unhealthy adulthood. The eating habits of a child can affect whether they'll have diabetes in their future, the environment they are exposed to affects their risk of certain detrimental behaviors. Just the same, healthy eating habits can have a positive effect on their health in adulthood. A balanced diet can lead to practicing good eating habits and being taught good coping mechanisms can lead to reduced stress levels.
9. Biology and genetic endowment
Aside from any decisions one can make to improve their health, genetics play a major role in determining one's health and likelihood in developing illnesses. Of course, one's behavior and habits can affect whether or not those illnesses are developed, but ultimately, genetics do affect one's health just as much as their environment does.
10. Health services
Along with income affecting one's access to health, there are many places where people are very far from health services and cannot access these services in their time of need. In rural places, for example. Sometimes, city life has its drawbacks as well. Some low-income communities have no emergency rooms nearby, making it difficult to make the trip when someone is ill.
Moreover, when in the hospital, prejudices still take place. Although it is an issue that has been brought to the forefront, there are times in which doctors treat patients differently because of how they look. The homeless, for example, are treated with less patience than other patients. Getting into the services that patients are not aware are available to them can make it more difficult for the patients to get the proper care they need and deserve.
11. Gender
Men and women face different diseases at different ages. Men, for example, can develop prostate cancer. Although most of these men die with prostate cancer rather than of it, it can affect their quality of life. Women, on the other hand, can have polycystic ovarian syndrome, which will also affect their quality of life. Trans men and women can also suffer from various illness, some of which may be brought up by the hormones they are prescribed, depending on the chemistry of their bodies. I'd like to clarify that physical health is not the only thing that can be affected, as mental health is also an important topic.
12. Culture
Perceptions of health, illnesses, and death can affect people's approaches to diseases and health promotion. Believing in and promoting abstinence before marriage, for example, has been shown to lead to higher teen pregnancy rates because although it is perfectly fine to believe in sex after marriage, leaving teens ignorant about the consequences of sex can lead to them acting upon themselves before considering the consequences. Not considering mental health as a real health problem can also lead to problems. People will be afraid to reach out to psychologists because it is not heard of in their culture and that can lead to the worsening of their problems.
It is very important to keep these factors in mind as one goes through the health system. Pre-med, or not, these are very important as they play a role in everyone's lives. If you are in a position to advocate for better health systems, increasing and improving health promotions, and equity in the health system, please do so as there are many who cannot advocate for themselves.