In November, Change Matrix (CM) held three Learning, Being, and Doing (LBD) sessions about the Social Determinants of Health (SDOH). Healthy People 2030 defines the SDOH as “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” The SDOH are frequently used when framing projects around health equity — like in this CM project and the World Health Organization — and they serve to showcase the forces that contribute to health disparities.

Over the course of the three sessions, CM explored the history of the SDOH and the use of the term, how and why the SDOH are intended to contribute to health equity, and where they succeed and fall short in this goal. The group was then challenged to think about all the SDOH factors addressed in CM’s various projects and to use upstream, midstream, and downstream approaches to refine the term “SDOH” to be more equitable. The team came to these conclusions:

What’s Wrong With the Term SDOH?

  • The term “social” doesn’t fully capture the different ways people are impacted by these health factors.
  • The word “determinant” feels permanent, as if what you are born into or born as predicts your future.
  • The term sounds too much like jargon and is primarily used in public health circles.

What’s Right With the Term SDOH?

  • Historically, the SDOH have helped to broaden understanding of how health has been impacted by external factors.
  • It can point out how systems should be held accountable for health outcomes.
  • The term provides a narrative into understanding one’s health beyond the individual level.

How Would You Refine or Update the SDOH?

  • Updating the term “social” to “structural, societal, or even systemic.”
  • Adding political and environmental factors to the term “social,” and would be more explicit in defining how the term “social” is used.
  • Focusing more broadly on a term that feels interrelated like “ecosystem of health.”

Additional Resources About the SDOH

SDOH Citation

Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [December 21st, 2022], from https://health.gov/healthypeople/objectives-and-data/social-determinants-health