Addressing the Social and Political Determinants of Health

Addressing the Social and Political Determinants of Health Requires Broad, Unified Action – and Immediate Focus

By Squire Servance, Founder and Managing Partner of Syridex Bioand Michellene Davis, Esq., President and CEO of National Medical Fellowships

Following the COVID-19 pandemic, the deep disparities in American healthcare have never been clearer. Though the virus’ threats have receded, symptoms of the underlying problem continue to multiply: The U.S. life expectancy is at its lowest in nearly two decades. 

Communities of color, in particular, remain hardest hit by health disparities: Black people are almost four times as likely as white people to develop kidney failure; Latina/Hispanic women have triple the likelihood of dying of HIV infection. These are merely examples of a widespread crisis.

Untangling the complex matrix of systemic issues in our health system can seem like a monumental task. However, understanding the social and political determinants of health (SPDOH) – and our potential agency within them – offers a practical and wise place to start. 


Social determinants of health are defined by the CDC as “nonmedical factors that influence health outcomes”—that is, the conditions in which people are born, along with the larger systemic forces that shape their daily lives. Social determinants can have an outsized impact on health outcomes, more so than even health care or lifestyle choices. 

The Department of Health and Human Services organizes the social determinants of health into five categories: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. We complement these social determinants with political determinants of health — which, as health policy expert Daniel Dawes explains, involve the “systematic process of structuring relationships, distributing resources, and administering power in ways that either advance health equity or exacerbate health inequities.” 

Together, these social and political determinants of health (SPDOH) reveal both person-by-person and systemic disparities in health outcomes, adding up to basic and deeply rooted health care inequity. 

Addressing – and dismantling – these inequities requires urgent, cross-sector, collaborative action akin to the global pandemic response. Indeed, lives are at stake, and success takes a village.

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