Determinants of Health

Understand the Problem

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Health, including mental health, begins long before we go to the doctor’s office.

Health starts where we live, learn, work, and play. Sometimes this is referred to as the "social determinants of health" (SDOH).

Below are five key areas that impact our mental and physical health:


Economic stability

Economic stability is the connection between health and finances like income, cost of living, and socioeconomic status.

For example, research has shown a connection between unemployment, unstable employment and increased psychological stress which can negatively impact mental health.



Education access and quality

Education access and quality is the connection between health and education. This includes K-12 education, higher education, and literacy. For example, greater access to education has contributed to more positive mental health for individuals and communities.



Health care access and quality

Health care access and quality is the connection between a person’s wellbeing and health services. This includes having access to health care facilities, health insurance coverage, and health literacy/navigation. For example, barriers to healthcare like long distances, lack of available appointments, or high costs can all impact getting access to treatment for mental health conditions or substance use disorders.



Neighborhood and built environment

Neighborhood and built environment is the connection between health and a person’s housing, neighborhood, and other environmental factors. This includes a variety of factors like quality/affordability of housing, transportation, access/availability of healthy foods, air/water quality, and neighborhood safety. For example, research has linked ongoing exposure to poor housing conditions with negative mental health.



Social and community context

Social and community context is the connection between health and social or community interactions. This includes community cohesion, community participation in government, discrimination, workplace conditions, and how many people are in jail or prison. For example, social support and a sense of community belonging have been associated with various positive mental health outcomes.



To promote mental health and prevent substance use it is important to make sure that all Americans have the chance to make healthy choices with any income level, education level, or racial/ethnic background.

To learn more about the work being done to achieve this, please visit the Community-Based Interventions and Policy Solutions sections of this web library.