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What Are Social Determinants of Health and Why Do They Matter?

By Heather Kerrigan | Apr 15, 2019

Rising rates of chronic disease and premature death often aren't the results of a failure to seek medical care alone. In fact, inadequate nutrition, unsafe environments, lack of transportation and poor social networks can undermine health long before an individual ever sees a doctor.

A growing body of research suggests that to improve overall health outcomes, focus must be placed on the social determinants of health — the circumstances of the environment in which someone is born, lives, works, learns and plays. To keep your membership healthy, you must facilitate access to the resources that enhance quality of life and are essential for overcoming negative social and environmental determinants of health.

Social Determinants of Health

The federal Office of Disease Prevention and Health Promotion identifies five overarching social factors that impact health:

  1.  Economic stability.
  2.  Education.
  3.  Social and community context.
  4.  Health and health care.
  5.  Neighborhood and built environment. 

These factors are primarily shaped by distribution of wealth and resources and frequently contribute to serious chronic illnesses. They can trap individuals in a harmful cycle: Someone with poor overall health may be unable to take advantage of certain employment opportunities, which in turn reduces their earning potential. Those with lower wages have higher stress levels and lack the resources to afford health care and nutritious food, which negatively impacts overall wellness.

Studying your membership to understand the most common social determinants your members face can help you piece together a picture of overall population health and the drivers preventing members from achieving optimal wellness. Understanding the social determinants within your member population is critical to providing access to the right resources and benefits.

6 Steps to Help Members Overcome Negative Social Determinants

Considering the significant impact that an individual's environment can have on their health, simply providing access to health care providers isn't enough to improve outcomes. While the union can't eliminate crime in a neighborhood or improve the quality of education, there are some critical factors of a member's environment that the union can address. These include:

  1.  Collective bargaining. An essential function of the union is to ensure members have safe working conditions, fair wages and access to the benefits they need. According to the Centers for Disease Control and Prevention, poverty inhibits access to the resources individuals need to thrive, and the work the union does at the bargaining table is critical to keeping members out of poverty-driven, suboptimal health cycles.
  2.  Access to the right benefits. Ensure that the health insurance benefits members receive are the ones that can address the negative social determinants of health you've identified in your population. This includes access to local doctors (including transportation) and programs to help overcome health concerns like addiction. Further, remove barriers to entry for these benefits. Lower-income members, for example, may not be able to afford high copays. And promote health literacy to ensure your members understand their benefits and how to take advantage of the care they have access to.
  3.  Health promotion. Make healthy living an element of all union activities, specifically geared toward the negative determinants you've identified among your membership. If a significant portion of your members live in a food desert, partner with community organizations to establish a farmers market. You can also work with employers to remove junk food from workplace vending machines.
  4.  Member liaisons. Make sure your union representatives have information to disseminate to members who may be struggling with one of the negative social determinants of health. This should be more than just information on union-provided benefits and could include upcoming training opportunities; resources for mental health care; smoking cessation programs; or local, state and federal safety net programs.
  5.  Training. Ongoing, targeted training allows a member to continue building the skills that are vital for career advancement, thus making higher wages and job satisfaction more likely.
  6.  Social supports. Provide ample opportunity through regular union meetings and events for members to come together with their peers to reduce stress. 


Negative social determinants harm an individual physically and emotionally, and put the union and employer at risk — health care expenses rise, worker satisfaction decreases and premature death becomes more common. As a union, you play a significant role in getting your members access to the resources and benefits they need for their overall well-being.

Heather Kerrigan started her career in journalism at Governing magazine, reporting on state and local politics and policy, with a specific focus on public workforce, environment, health care, education and technology issues. Prior to co-founding River Horse Communications, Heather offered freelance editorial services to a variety of outlets, including serving as volume editor and lead author for SAGE Publications' Historic Documents series and editor-in-chief of The Kanter Journal. Heather also blogs for two government-focused publications, GovLoop and NEOGOV, covering issues of importance to federal employees. Heather is the author of the book Retire Rich With Your 401(k) Plan. She holds a bachelor's degree in journalism from The George Washington University.