How much do social determinants matter to our health?

What Makes us Healthy?

We have an intuitive sense that things like what we eat, how much we exercise, the quality of our water and air, and getting appropriate health care when sick all help us stay healthy. Studies have also shown that our incomes, education, even racial identity is associated with health — so called “social determinants of health.” How much do social determinants matter? How much does the health system improve our health?

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Let us know what you think makes us healthy. Play our interactive game and “connect the dots” to tell a story. Save your selection, share your journey on social media, and help us with our research.

Drivers of Health: What do we know?

In the last forty years, much has been done to quantify the contributions of various factors to health. What can we learn from this collective body of research? In an extensive literature review, we provide a historical background and summarize a selection of scholarly work on the drivers of health, including frameworks to organize social and health system determinants of health.

  • From our Blog

    When black patients see non-black doctors

    African American men live about 4.6 fewer years than non-Hispanic white men. There are many causes contributing to the difference, including a learned mistrust of the health system by African Americans. Another set of potential factors arises when non-black physicians treat black men. According to a study published earlier this year, that care just isn’t

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  • From our Blog

    The Proximal/Distal Paradigm

    Factors that affect health are often described as either “proximal” (downstream or directly affecting health) or “distal” (upstream or indirectly affecting health). For example, income is thought of as distal (upstream) because it doesn’t directly affect health.

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  • From our Blog

    The legacy of the Tuskegee study

    In the United States, African American men have the worst health outcomes of any major demographic group. At age 45, their life expectancy is more than three years less than that of non-Hispanic Caucasian men and more than five years less than African American women.

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  • From our Blog

    What is known about drivers of health: a literature review

    While there is widespread understanding that the health system and other factors — social determinants — affect health, we know relatively little about their precise contributions to health differences across a population at a point in time or differences in health of a fixed population over time.

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  • From our Blog

    Allocating health outcomes to risk factors, part 3

    A common way to assess how much various factors contribute to health is to estimate how much variation in health across the country is explained by each of those factors. But explaining variation is not as useful as many may think.

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