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Social Drivers vs. Social Determinants of Health: Unstacking the Deck

A Whole Health Story February 25, 2022

A man battling multiple complex health conditions suddenly found himself facing eviction with no time to spare. He was set to be kicked out of his apartment within days for an unpaid bill. How could he focus on improving his health with no roof over his head? The social drivers of health, sometimes called social determinants of health (SDH), were suddenly all too real. He needed help and the clock was ticking. His urgent need to secure housing is just one scenario where health can be directly impacted by social factors.

Why We’re Using the Word  Drivers  Instead of  Determinants  

Social drivers, also known as social determinants of health, are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes. However, “determinants” suggests nothing can be done to change our health fate. By saying social factors drive our health, we reframe the conversation about health. We show that social factors don’t force health to be fated or destined, but rather they are something that people and communities can overcome or change.
 

How Social Drivers Impact Whole Health

Up to  80% of health outcomes are influenced by non-clinical factors, such as access to nutritious food, reliable transportation, quality housing, and financial stability – meaning that most of our health is driven by things that happen outside of the doctor’s office. In fact, our health is increasingly determined more by the ZIP code we live in than the doctor we see. But there’s work to be done to help people see and understand social drivers. As explored in our 2021 report  Driving Our Health: A study exploring health perceptions in America, nearly half (46%) of Americans are unaware of the concept of social drivers of health. 
 

Driving Change by Broadening Our View of Health

Whole health is an approach to healthcare that recognizes health must be evaluated as a bigger picture, one that includes physical, behavioral, and social drivers. We must move beyond the traditional scope of simply addressing physical health and find ways to positively influence behavioral and social drivers of health. This involves a focus on health equity and using data to tailor our efforts to individuals, taking a big picture view of their health needs. Only by understanding this big picture can people start to view their own health as something that is both influenced by the world around them and within their control to shape and change.  

The  What’s Driving Our Health initiative aims to improve understanding of whole health and its drivers, and we’re collaborating with local and national partners to build a new system of health.   

“We believe that everyone should have the opportunity to be and stay healthy. This starts by taking a broader view of health and understanding that while the world around you drives your health, you still have control over it. We are looking at the many factors that contribute to individual health and partnering in the smartest ways to improve it,” said Shantanu Agrawal, MD, chief health officer at Elevance Health.   

By working together to acknowledge the social drivers of health, we can unstack the deck and advance health equity. 

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