Evidence Review: Social Determinants of Health for Veterans [Internet]

Excerpt

Social determinants of health are broad and often defined in the context of other factors that also impact health. For example, the Institute of Medicine's (IOM) report, Capturing Social and Behavioral Domains and Measures in Electronic Health Records, defined social determinants as “sociocultural, socio-economic, and socio-demographic status; biosocial interactions; and the various levels of social context…” This IOM report differentiated social from behavioral factors in that the latter indicate observable actions, underlying cognitions, and/or other related psychological constructs. Similarly, Tarlov's framework posited “social and societal characteristics” as one of 5 major categories of determinants of population health, with the others being genes and biology, health behaviors, medical care, and the “ecology of all living things.” Although exact definitions vary somewhat, there is consensus that social determinants include many distinct concepts, and taken as a whole, they substantially influence health outcomes and contribute to health disparities.