Social Determinants of Health

Social determinants of health are the social, economic and environmental conditions in which people are born, grow, live, work and age. They shape exposure to risks, access to resources and the capacity to obtain care, thereby producing differences in health outcomes. The framework therefore treats health as more than the result of biology, individual behaviour or medical services.

Major determinants

Health is influenced by the distribution of resources, opportunities and power across society.

• Income and employment affect nutrition, housing, working conditions and the ability to meet healthcare costs.
• Education influences health knowledge, employment opportunities and the capacity to navigate public services.
• Caste, class and gender can shape discrimination, occupational exposure, autonomy and access to food, sanitation and healthcare.
• Housing, safe water, sanitation, clean air and neighbourhood conditions determine exposure to disease and injury.
• Social support, early-childhood conditions and access to public services influence physical and mental well-being across the life course.

How social conditions affect health

Structural determinants, such as social stratification and public policy, locate groups differently within society. They operate through intermediary determinants, including material conditions, psychosocial stress, behaviours, occupational risks and healthcare access.

• Disadvantage may accumulate over the life course, beginning with maternal health and childhood nutrition.
• Determinants interact: low income may lead to poor housing, hazardous work, inadequate nutrition and delayed treatment.
• Health differences become health inequities when they are systematic, avoidable and socially unfair.

Public-health implications

The framework shifts policy from treating illness alone to prevention and action across sectors. The National Health Policy, 2017 recognises that improved health requires coordinated action on wider determinants.

• A Health in All Policies approach considers health effects in education, labour, housing, transport, environment and social-protection decisions.
• Universal public services should be combined with focused support for populations facing greater disadvantage.
• Disaggregated data by social group, sex, region and income can reveal unequal exposures, access and outcomes.
• Community participation and action against discrimination improve both service responsiveness and health equity.