Social Determinants of Health in Action
Here is a concrete example of social determinants of health in action: As the Dallas Morning News reported recently, the local communities with the highest and lowest life expectancy are only 20 miles apart. (The communities are divided by census tracts, which are geographic regions defined for the purpose of taking a census.) In one census tract, located in an area of Oak Cliff, residents live just 64.2 years on average. In the other, located in a part of Richardson, residents live 86.5 years on average—the highest life expectancy in Dallas County.
This means the Oak Cliff residents are missing out on a full two decades of life.
What is behind this huge disparity? A variety of social determinants of health are at play here. For starters, in the Oak Cliff community, 50.9% of residents are Latino, 44.7% are Black and 14.2% are white. In the Richardson community, 77.4% of inhabitants are white, 10.6% are Asian and 6.2% are Latino. The Oak Cliff residents are more likely to be subject to discrimination in every aspect of their lives, which has been shown to have a negative impact on health and wellbeing.
In addition to racial disparities, the two communities also have drastic differences in income, access to health care and the type of work residents do. In the Oak Cliff community, the nearest grocery store or health clinic is several miles away, and residents report high crime. In Richardson, residents can easily access fresh groceries and quality health care, and residents report a relatively stress-free lifestyle.
Meanwhile, other social determinants of health may be affecting these two communities. For example, if many of the Oak Cliff residents have lower incomes, they are more likely to experience food and housing insecurity, which harms health and development, especially for children. Groups with a lower level of education report having poorer health than those with more education, according to WHO. Even things like working multiple jobs or having significant debt can hurt a person’s health over time.
To make matters worse, many North Texans dealing with overlapping social determinants of health have seen their challenges increase exponentially during the COVID-19 pandemic.
As Susan Hoff, chief strategy and impact officer at United Way of Metropolitan Dallas, explains, “Those who were already disproportionately impacted by debt and other social determinants of health, that’s only been exacerbated in the last two years.”