July 2017

Overview

Social determinants of health (SDOH) are the conditions in the environment in which people are born, grow, live, work, and age¹ that may impact their health. SDOH are often a strong predictor² for health inequities—the unfair and avoidable differences in health status seen within and between communities.¹ They include factors like socioeconomic status, education, the physical environment, employment, and social support networks, as well as access to health care.³

The Healthy People 2020 SDOH framework highlights 5 key domains: economic stability, education, health and health care, neighborhood and built environment, and social and community context. The selection of social determinants as a Leading Health Indicator recognizes the critical role of home, school, workplace, neighborhood, and community in improving health.⁴ The Social Determinants LHI encourages improvements in education and high school graduation rates. Children born to parents who have not completed high school are more likely to live in an environment with barriers to health.⁵ Additionally, low education levels have been linked with poor health, more stress, and lower self-confidence.⁶

Increasing levels of education, including academic success and achievement, are associated with longer life expectancy, improved health and quality of life, and adoption of health-promoting behaviors like getting regular physical activity, not smoking, and going for routine checkups and recommended screenings.⁷

Leading Health Indicators

Leading Health Indicators (LHIs) are critical health issues that—if tackled appropriately—will dramatically reduce the leading causes of death and preventable illnesses. The Social Determinants LHI is:

• Students who graduate with a regular diploma 4 years after starting 9th grade (AH-5.1)

Other key areas are critical to addressing social determinants and improving population health; learn more about additional social determinants of health.

Where We’ve Been and Where We’re Going

The on-time graduation rate in public schools, defined as the percentage of students awarded a high school diploma 4 years after starting 9th grade, increased by 5%, from 79% for school year 2010–11 to 83% for 2014–15, moving toward the HP2020 target of 87%. During the same time period, Hispanic, American Indian or Alaska Native non-Hispanic, and black non-Hispanic students had the greatest relative increase in on-time graduation rates (10–12%). For the 2014–15 school year, Asian or Pacific Islander non-Hispanic students had the highest rate of on-time graduation among racial and ethnic groups.

Explore the Latest Data

Who’s Leading the Leading Health Indicators?

Increasing Graduation Rates in Our Nation’s Public High Schools

Founded in 2008, Diplomas Now is a partnership of 3 national nonprofits—Talent Development Secondary, City Year, and Communities in Schools—working to transform the Nation’s most challenged middle and high schools in high-poverty areas. Its model brings staff from all 3 partners into schools to restructure the way classes are organized and taught, identify students who need support, and provide the additional people and training needed to respond.

Leading Health Indicator Infographic

¹ http://www.who.int/social_determinants/sdh_definition/en/

² https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Social-Determinants/determinants

³ http://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/

⁴ https://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf (p6)

⁵ Singh G, Siahpush M, Kogan MD. Neighborhood Socioeconomic Conditions, Built Environments, and Childhood Obesity. Health Affairs. 2010;29(3):503–512. doi: 10.1377/hlthaff.2009.0730

⁶ http://www.who.int/hia/evidence/doh/en/

⁷ https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Social-Determinants

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