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Writer's pictureAlexus Davis

Social Determinants of Health

Updated: Feb 12, 2018

Presentation: Population Health Management

Douglas King, Stantec, Senior Associates


Douglas King, a Senior Associate at Stantec Architecture, visited our class to present information on his research about “Population Health Management Strategies.” Towards a design of healthier cities.

“Population Health is a systematic approach to healthcare that aims to prevent and cure disease by keeping people healthy.”

  • Kenneth Kizer, Director of the Institute for Population Health Improvement at the University of California at Davis Health System

Two Topics that stood out to me during the presentation were:

  1. Your education level and your zipcode determines your life expectancy.

  2. 80% of our health outcomes is determined by our Health Behaviors, Social & Economical Factors, and our Physical Environment.

These facts reminded me of a previous course I took on Environment, Behavior and Health; where we discussed how a set of factors known as the social determinants of health, impact our well-being. In this course, we discussed the topic “where you live determines how you live.” There is a growing body of knowledge towards understanding factors outside of the hospital and health system, that impact an individual’s health; and how these factors can be adjusted to improve your health and keep you healthy. This blog will only discuss the urban scale and dense cities.




An example of a group of people negatively impacted, would be people living in low-income, high crime and ethnic minority areas; where the living conditions are poor and the residents are exposed to chemicals within their home and within the air that make them sick. These residents also tend to live in food deserts where there is a lack in access to healthy food options; these communities can sometimes lack adequate access to healthcare facilities and many other resources that promote healthy living.


The World Health Organization defines the social determinants of health as:

“The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.”


Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world.


The social determinants of health include:

  • income and social status

  • social support networks

  • Education

  • employment/working conditions

  • social environments

  • physical environments

  • personal health practices and coping skills

  • healthy child development

  • gender

  • Culture

Health inequalities can be defined as differences in health status or in the distribution of health determinants between different population groups.

  • Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. (http://www.who.int/hia/about/glos/en/index1.html)

In Doug King’s presentation mentioned how 5% of the US population uses 52% of healthcare spending. This 5% is disproportionately disadvantaged, and many of this percentage lack something as basic as housing. There is a growing movement in Healthcare towards Health + Wellness and promoting healthy living at the Urban Scale.


A healthy city has been defined as “one that is continually creating and improving those physical and social environments and expanding those community resources that enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential”

  • Making Healthy Places: Chapter 10 Transportation and Land Use

Health Equity is not something that is easily achievable, as there are many factors on a political and structural level that impact why communities are shaped they way they are. Keeping this body of knowledge in mind, architects, urban planners, healthcare professionals, policy-makers and many people alike can begin to work together to fight towards the goal of Health Equity; that can lead to a healthier cities.


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