In a perfect world, everyone would have access to the healthcare they need — regardless of their standing in life. Unfortunately, we have not yet achieved this ideal. Social determinants of health (SDoH), including socioeconomic status (SES), play an integral role in shaping health outcomes, influencing everything from mental health to accessibility to medical services and even the aging process.
The field of public health plays an integral role in addressing both SDoH and SES. Various authoritative bodies underscore the importance of understanding SES in the context of public health. Graduates of the online Master of Public Health (MPH) program at Eastern Washington University (EWU) learn about SDoH and how SES affects people’s health and lives.
What Are Social Determinants of Health?
SDoH are the conditions in the environments where people live, work, learn and play that affect a wide range of health, functioning and quality-of-life outcomes and risks. These environments can be physical, such as our homes, workplaces and neighborhoods. They can also be social, reflecting the quality of our relationships and social networks.
The Centers for Disease Control and Prevention (CDC) and the Office of Disease Prevention and Health Promotion highlight SES as a crucial SDoH. Lower SES is often associated with poorer SDoH, leading to poorer health outcomes. The Office of Disease Prevention and Health Promotion identifies SES as a priority area in its social determinants of health framework.
The five categories of SDoH include:
- Economic stability
- Education access and quality
- Healthcare access and quality
- Neighborhood and built environment
- Social and community context
Each of these elements has a profound influence on health outcomes. For instance, economic stability affects access to food, housing and other basic needs. The quality of education can determine health literacy and job opportunities, changing income and access to healthcare.
Healthcare access and quality is a key determinant, as it dictates whether individuals can receive preventative care, manage ongoing health conditions and access emergency services when needed. The neighborhood and built environment involve factors like access to healthy food options, housing quality, crime and violence rates and environmental conditions. Lastly, social and community contexts encompass social cohesion, civic participation, discrimination, incarceration and stress.
SDoH, SES and Stress
The American Psychological Association (APA) has documented the complex relationship between stress and socioeconomic status. Lower SES is often accompanied by high-stress levels, primarily due to resource scarcity, job instability, unsafe housing and limited access to quality healthcare.
This chronic stress can trigger mental health issues like depression and anxiety and exacerbate physical health conditions like heart disease and diabetes — highlighting the interconnectedness of socioeconomic factors, stress and public health.
Healthcare Access Challenges
Healthcare access is not just about being able to afford medical care but also about geographical accessibility, quality of care and awareness about health services. This concept is further amplified for populations with low SES, who often face significant barriers to medical access.
These impediments can lead to late diagnosis, insufficient treatment and ultimately poorer health outcomes. Medical access is not merely a separate entity but a critical component of the broader SES conversation in public health.
SES and the Aging Process
SES also impacts the aging process. A study published by PNAS provides critical insights. Socioeconomic disparities are often mirrored in health outcomes, and these disparities become more pronounced with age.
Older adults with low SES will likely experience faster cognitive decline, more substantial disability burdens and premature mortality. The study argues that lower SES exposes individuals to more health risks throughout their life, and these accumulated risks manifest in later life, underscoring the lifelong influence of SES on health.
Optimize SES and SDoH Efforts With a Master of Public Health Degree
Socioeconomic status intertwines with almost every aspect of public health, from mental health to medical access and from aging to broad health risks and outcomes. To bring about a significant improvement, public health initiatives must tackle the root cause: socioeconomic disparities.
Without addressing SES, any attempts at health improvement will yield only superficial and temporary results. The conversation around SES and public health is an urgent and crucial one that we must continually expand and prioritize.
At EWU, the online MPH program equips public health professionals with the skills and knowledge they need to address SES as part of greater SDoH. In particular, the Health Equity and Advocacy course addresses SDoH among local, national and global populations and how factors like structural bias, wealth, racism and sexism influence health outcomes.
Health Policy and Law is another notable course, as it prepares students for the potential to address SES and SDoH from a governmental perspective. Given the accelerated nature of the online program, students can complete the coursework in as few as 14 months, so they can quickly become powerful health advocates.
Learn more about EWU’s online MPH program.
