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Social Determinants of Health


The daily conditions in which people live, learn, work and play have a major impact on health and wellbeing.  These conditions are termed the “social determinants of health.”  Research suggests that only about 20 percent of a person’s health quality is related to access to healthcare services.  The remaining 80 percent comes from a variety of non-medical, socially determined conditions, including health behaviors, socio-economic conditions and the physical environment in which a person is living their life.

Health behaviors include diet, exercise, tobacco use, alcohol use, non-prescribed drug use, and sexual activity.  The behaviors can either be healthy and constructive or unhealthy and destructive.  Our health behaviors have a significant influence and impact on our overall health.  Adopting healthy behaviors – things as elementary as eating an apple instead of a cookie, walking for 30 minutes rather sitting in front of a screen, drinking water rather than alcohol – can prevent, control and even reverse a variety of disease risks.  Health behaviors are influenced by a variety of variable conditions.  These include the individual’s unique biological and psychological chemistry, the environment immediately around them, and structural and political forces in the larger community. 

Factors that influence health behaviors fall into five categories that comprise the social determinants of health.  These factors, include demographic characteristics, socioeconomic status, physical environment, behavioral health and choice architecture, are linked to access to care, health outcomes and life expectancy.  For example, minorities living in low-income neighborhoods may experience more stressful events related to socioeconomic disparities and have limited healthy choice alternatives.  These conditions contribute to alcohol and drug abuse, depression, and physical inactivity – all unhealthy behaviors.

At SMA Healthcare our focus is on improving behavioral health for those confronted with addiction and/or serious mental illness.  It’s been said somewhat tongue in cheek that “recovery is easy, all you have to do is change everything.”  The grain of truth in that seemingly ominous statement is that recovery is more just addressing drug abuse or the symptoms of a serious mental illness.  Recovery is also related to identifying those social determinants  in a person’s life that contribute to unhealthy behaviors and beginning to learn and practice alternative healthy behaviors.  This often includes things like pursuing additional education or vocational training, budgeting, modifying diet and learning new processes for making healthy life choices. 

Using a social determinants of health perspective, it’s understandable that SMA’s strategic goals include improvement in the social characteristics of the broader community.  We advocate for safe, affordable housing, equal access to fresh, healthy food, and improved access to positive social networks that are consistent with our clients’ interests and beliefs.  Recovery is linked to and enhanced by the ability to make these types of healthy choices.   By improving our community’s social determinants of health we  all benefit, and improve our overall health and wellness.