Social Determinants of Health

One of the reasons governments invest money in the healthcare sector is to improve medical infrastructure for better health outcomes. Nevertheless, the World Health Organization (WHO) has identified critical non-medical factors that are equally influential to health outcomes (WHO, 2021). Such factors are conditions in the environment, which are called Social Determinants of Health (SDOH). The SDOH are grouped into five domains: economic stability, access to quality education, access to quality healthcare, neighborhood and built environment, and social community and context (WHO, 2021). The five domains feature critical issues that concern inequities and disparities from community to national levels. For instance, people who live far from a grocery store stocked with healthy foods are less likely to be more beneficial than those who can access a grocery store stocked with healthy foods. On a national level, third-world countries with poor infrastructure are likely to delay the complete vaccination of their populations due to challenges associated with accessibility. 

This project is particularly interested in d neighborhood and built environment domain. The U.S. Department of Health and Human Services has borrowed from the SDOH to recognize neighborhoods as a critical factor that determines health outcomes (“Healthy People 2030”, 2021). The department defines neighborhoods as “places where people live, work, learn, and play” and is continuously improving them to through interventions and policy changes from local to federal levels of governance (“Healthy People 2030”, 2021). Such interventions and policies seek to overcome issues such as violence, safety risks, and lack of access or unsafe amenities.

The relationship between the SDOH and medical factors is somewhat intriguing; for instance, the CDC has found that the obesity epidemic among adults in the U.S. is influenced by the community environment, among other factors (CDC, 2021). The CDC briefly explains that distance from the house to a grocery store (in other words, access to food) and means of accessibility may encourage or discourage healthy lifestyles such as walking or taking a bike. Although the association between obesity and the environment is often underappreciated, many studies (as reported in a systematic review) have found equivocal evidence for the association (Lam et al., 2021). The purpose of this project is to report the empirical evidence concerning the association of the rate of adult obesity and the number of groceries in their neighborhood.

From the table, data from the Houston State of Health indicate that the percentage of overweight and obese adult increase with an increase in the number of grocery stores near them. Also, the Zip codes with the least number of groceries met the HP2020 target, which was a 10% improvement over the baseline 38% of the adult population with obesity (BMI≥30) (Office of Disease Prevention and Health Promotion, 2021). These results indicate that the more groceries there are in a neighborhood, the more likely a neighborhood resident is to become obese. It may be associated with promoting either healthy or unhealthy lifestyles such as walking and bikias ng, as suggested by a recent study (Lam et al., 2021). However, this study has limitations such as lack of a control sample and disregard of extraneous variables.

To sum up, non-medical factors that influence health outcomes are called Social Determinants of Health. They are grouped into five domains: economic stability, access to quality education, access to quality healthcare, social community and context, and neighborhood and build environment, which is the focus of this project. Data from the Houston State of Health indicate that people living in neighborhoods with many groceries are more likely to be obese than those living in a neighborhood with few groceries.

References

CDC. (2021). Adult Obesity – Causes and Consequences. Centers for Disease Control and Prevention. https://www.cdc.gov/obesity/adult/causes.html.

“Healthy People 2030”. (2021). Neighborhood and Built Environment – Healthy People 2030 | health.gov. Health.gov. https://health.gov/healthypeople/objectives-and-data/browse-objectives/neighborhood-and-built-environment.

Lam, T., Vaartjes, I., Grobbee, D., Karssenberg, D., & Lakerveld, J. (2021). Associations between the built environment and obesity: an umbrella review. International Journal Of Health Geographics, 20(1). https://doi.org/10.1186/s12942-021-00260-6

Office of Disease Prevention and Health Promotion. (2021). Nutrition, Physical Activity, and Obesity | Healthy People 2020. Healthypeople.gov. https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Nutrition-Physical-Activity-and-Obesity/data.

WHO. (2021). Social determinants of health. Who.int. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1.