Is it time to retire the term “Social Determinants of Health?”

In 2019, The Northwest AHEC re-prioritized our health education objectives to include non-medical drivers of health. These non-medical key drivers of an individual’s health (e.g. employment status, where we live, the air we breathe, our access to food and safe places nearby to exercise) have gained an elevated status in improving public health. This is noted in the Office of Disease Prevention and Health Promotion’s seminal work on preventing premature injury, the Healthy People 2030 Framework. Healthy People 2030 in its foundational principles includes: healthy physical, social, and economic environments to strengthen the potential to achieve health and well-being.

The phrase chosen to encompass these non-medical factors is “social determinants of health”. This term and its drivers are examined by a study in the article we have selected for our bimonthly Social Determinants of Health segment, entitled What We Need To Be Healthy—And How To Talk About It (Health Affairs Blog, Lumpkin et al., 2021). The authors detail results from tandem focus group efforts by Democratic and Republican polling firms that reviewed thoughts and opinions of 120 registered voters in Raleigh, Charlotte and Hendersonville, North Carolina. Many of these exchanges revealed that there is consensus around the importance of non-healthcare drivers of health. Participants were asked how they would spend funding if given decision-making power. Most participants chose to fund drivers of health, not health care settings.

Another key finding of the focus groups assembled is the imprecise language common in healthcare settings. The phrase “Social Determinants of Health” was highlighted as an ambiguous term which distracted from the issues it encompasses. The word “social” is seen to refer to online communities or social networks in today’s lexicon. The word “determinants” was considered by voters to imply that the individual lacked agency over their own health outcomes.

We are seeking input on how the term “Social Determinants of Health” is valued by our partners. Is it time to select a more appropriate phrase to utilize? Take our survey to add your input as we consider this complex issue.

The Northwest AHEC Practice Support Team is committed to promote understanding and improve the orientation of Social Determinants of Health (SDOH) for North Carolinians. In order to support these goals, we will share a publication on SDOH each month on our Practice Support Blog.