Types of Social Determinants of Health

The social determinants of health (SDOH) encompass several different types or factors that contribute to the health of rural communities. This section organizes SDOH into five key categories, using the Healthy People 2030 SDOH place-based framework. For more information about each SDOH domain, see Program Models in Module 2.

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 employment and the work environment, food access and food security, safe and affordable housing, and income and financial resources.

Education access and quality is the opportunity to participate in and the effectiveness of educational programs. For example, early childhood education and development contributes to improved health outcomes and well-being, both in childhood and later in life.

The social and community context in which people live includes the relationships formed between neighbors and the impact of community participation on community outcomes. SDOH in this domain include civic engagement, voting, incarceration, and social cohesion.

Healthcare access and quality has a direct impact on health outcomes and quality of life. Several factors can affect healthcare access, such as health insurance coverage, distance to healthcare settings, and the availability of healthcare 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 the Healthcare Access in Rural Communities Topic Guide.

Neighborhoods and built environment 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.