What Are Social Determinants in Health and Social Care?

Social determinants in health and social care are the conditions in which people are born, grow, live, work, and age. These factors influence their overall health, wellbeing, and access to social care services. They often interact with one another to shape an individual’s quality of life. Understanding these determinants helps explain why people experience differences in health outcomes, access to services, and life expectancy.

These determinants are not just medical or biological. They include social, economic, environmental, and political factors. Social care ensures that individuals receive the support they need, but these wider determinants often determine how accessible and effective that support is.

Examples of Social Determinants

Social determinants cover a wide range of factors. Some common examples include:

• Income and financial stability
• Education and literacy levels
• Employment and working conditions
• Housing and living environments
• Social and community networks
• Access to healthcare services
• Early years development
• Racism and discrimination
• Transport and mobility
• Social protection and welfare systems

Each of these influences a person’s ability to live a healthy and fulfilling life, and they often overlap.

Income and Financial Stability

Income affects nearly every aspect of daily life. Individuals with stable and sufficient income can afford better housing, nutritious food, and healthcare. Low income, on the other hand, increases the risk of poor health. Poverty narrows opportunities for social advancement and limits access to services, leading to a vicious cycle of disadvantage.

Poor financial stability often leads to stress, which can contribute to mental health issues. It can also mean people must make difficult choices, like prioritising food over paying for heating or medication.

Education and Literacy Levels

Education has a strong influence on health and social care outcomes. Higher levels of education are linked to better employment prospects, higher income, and improved understanding of health services. People with greater literacy are more likely to engage in preventive healthcare and understand how to manage long-term conditions.

Lower education levels often lead to limited job opportunities. This can reinforce existing inequalities and make it harder for people to improve their circumstances. Difficulty understanding healthcare advice is a common challenge for those with limited literacy.

Employment and Working Conditions

Employment shapes health in direct and indirect ways. A steady job means a regular income and often access to employer-provided health benefits. However, the workplace itself plays a role. Unsafe, low-paying, or overly stressful jobs can harm a person’s mental and physical wellbeing.

Unemployment also has significant health effects. Being out of work often leads to financial struggle and stress. It can limit access to healthcare and social services. Long-term unemployment is connected to poorer mental health outcomes and higher levels of social isolation.

Housing and Living Environments

Housing conditions directly impact physical and mental health. Poor-quality housing, damp conditions, overcrowding, and unsafe buildings pose risks to health. Inadequate housing can lead to respiratory illnesses, accidents, and long-term mental health problems.

Living in neighbourhoods with limited access to parks, shops, or transport can also reduce quality of life. These living environments can constrain opportunities for socialising, exercising, or accessing services, which further negatively impacts health.

Social and Community Networks

Support from social and community networks can be a protective factor for health and wellbeing. People who have strong family connections or community ties often experience less isolation, better mental health, and quicker recovery from illnesses.

Having limited social support can leave people vulnerable to stress, depression, or loneliness. Stigma, discrimination, and weak community cohesion can all limit the strength of these networks.

Access to Healthcare Services

The ability to access essential healthcare is a key social determinant. People with easy access to GP services, hospitals, and specialists are at an advantage when it comes to managing health conditions. They are more likely to receive preventive care and early treatment for illnesses.

Barriers to healthcare, such as distance to services, long waiting times, or lack of affordability, can worsen existing health problems. Discrimination or language barriers in healthcare settings can also prevent people from seeking the help they need.

Early Years Development

The foundation for health later in life is often laid in the early years. Nutrition, education, and social support during childhood play significant roles in determining a person’s future health.

Children brought up in poverty or neglect are at a greater risk of developmental delays. This disadvantage can persist into adulthood, affecting education, job prospects, and relationships. Early intervention services help reduce these risks, but access to these is often determined by the broader social factors a family experiences.

Racism and Discrimination

Social inequalities and discrimination—whether due to race, ethnicity, gender, disability, or sexual orientation—are major social determinants. These issues create barriers to accessing services, employment, housing, and education.

Discrimination and systemic racism lead to poorer health outcomes in affected populations. People in marginalised groups may avoid seeking help for fear of being treated unfairly. Racism also contributes to stress, which itself is a recognised health risk.

Transport and Mobility

Transport is often an overlooked social determinant, but it plays a large role. Individuals without access to reliable and affordable transportation may struggle to attend medical appointments, school, or work. Limited mobility can leave people isolated, especially in rural areas with poor transport links.

Good public transport systems or community transport schemes help people stay connected and access services. Poor transport creates barriers that worsen health inequalities.

Social Protection and Welfare Systems

Social protection systems, such as benefits or housing assistance, provide a safety net for individuals and families during hard times. This support can reduce the impact of poverty on health and wellbeing.

Cuts to welfare or inaccessible programmes make it harder for vulnerable groups to get the help they need. Over time, this can increase health inequalities and put additional strain on social care providers.

The Role of Social Determinants in Health Inequalities

Social determinants are at the core of health inequalities. They explain why some people live longer, healthier lives while others struggle with poor health. People in lower socioeconomic groups often have worse health outcomes than those in higher groups.

Inequalities begin with opportunity. For example, a child born into a wealthy family will likely have better housing, nutrition, and education. That child is less likely to grow up in poverty or experience unemployment as an adult. In contrast, someone born into a disadvantaged family faces obstacles from the outset.

Closing these health gaps requires improving the social determinants. More equal access to education, housing, and healthcare benefits everyone and helps build a society that supports good health for all.

How Health and Social Care Services Tackle Social Determinants

Health and social care services work to address social determinants in various ways. Programmes often focus on vulnerable or at-risk groups to reduce barriers and promote better outcomes. Examples include:

• Subsidised housing projects
• Food banks and nutrition support
• Vocational training and education schemes
• Initiatives to improve community cohesion
• Early years services, such as parenting groups
• Outreach programmes in disadvantaged areas

Multi-agency collaboration is key to this work. Health services, councils, voluntary organisations, and community groups often work together to address widely shared challenges.

Issues in Tackling Social Determinants

Addressing social determinants takes time, funding, and coordinated efforts. Limited resources and budget constraints mean services cannot always reach everyone in need. Political policies and priorities at national and local levels also shape what kinds of funds are available.

Other challenges include:

• Changing demographics
• Increasing demand on healthcare
• Language barriers among diverse populations
• Growing rates of chronic conditions linked to poverty

These challenges mean that progress is often uneven. However, evidence shows that focusing on education, reducing poverty, and promoting fair access to services makes a significant difference to outcomes.

Final Thoughts

Social determinants are about much more than individual choices. They’re the wider influences and structures that affect health, wellbeing, and access to care. By recognising these factors, health and social care systems have a better chance of providing effective, person-centred support.