Types of Social Determinants of Health
This section provides an overview of several different types of social determinants of health (SDOH) and factors
that contribute to the health of rural communities. Using the Healthy
People 2020 SDOH place-based framework, these SDOH are organized into five categories. For more
information about each of these domains, see Program Models in
Economic stability is related to employment status and the ability to earn a reliable and
livable income. Economic stability also includes factors that relate to safe and affordable housing and access
to healthy and affordable foods. The main factors that comprise economic stability include:
attainment is another important SDOH. Early and continued education of a child can have a positive
impact on his or her health and well-being later in life. A focus on early
childhood education and development is particularly important for improving health outcomes. This SDOH
domain includes language
development and literacy. In urban areas, increasing college graduation rates can improve community
outcomes, but this approach may not have the same impact in rural areas. Rural residents who leave their
community to attend four-year colleges often do not return to work in the community. This is one of several
important considerations for programs addressing SDOH in rural communities.
The social and community context in which people live includes the relationships formed between
neighbors, as well as the impact that voting and civic engagement has on community outcomes. Several SDOH that
are included in this domain are:
to healthcare has a direct impact on health outcomes and quality of life, and several
factors can both facilitate and hinder access, such as health
insurance coverage, distance to healthcare settings, and the availability of health providers. Aside from access
to health services, other SDOH that fall within the healthcare domain include health
literacy and the provider workforce. For more information, see RHIhub's Healthcare Access in Rural
Communities topic guide.
Neighborhoods and built environment can also influence the health of rural communities. Sidewalks, bicycle
lanes, walking trails, and green space in communities can improve physical activity and promote healthier
living. In addition, a lack of attention to accessibility features in the design of community spaces can limit
access for older populations and people with disabilities.
Several SDOH that are related to neighborhood and built environment factors include:
- Access to stores that sell healthy foods
Access to transportation
Resources to Learn More
CDC Research on SDOH
A compilation of evidence-based models and promising approaches for improving health equity based on the Healthy
People 2020 SDOH framework. Includes resources on economic stability, education, social and community context,
health and healthcare, and neighborhood and built environment.
Organization(s): Centers for Disease Control and Prevention
A compilation of resources, organized by category, describing how specific SDOH affect health outcomes.
Organization(s): Office of Disease Prevention and Health Promotion