Social Determinants of Mental Health
Social, economic and environmental factors that influence health are referred to as social determinants of health (SDOH). Examples of social determinants include economic stability, education, social and community context, access to health care and health literacy, and the built environment.
The importance of social determinants of health are recently recognized as important to overall health, including mental health. According to the World Health Organization:
Social inequalities are associated with increased risk of many mental health conditions. Taking action to improve the conditions of daily life from before birth, during early childhood, at school age, during family building and working ages, and at older ages provides opportunities both to improve population mental health and to reduce the risk of those mental conditions that are associated with social inequalities… Scientific consensus is considerable that giving every child the best possible start will generate the greatest societal and mental health benefits.
While high quality, affordable health care is essential, nonmedical factors – including social, environmental and behavioral factors -- play a larger role in determining overall health and well being.
State & National Initiatives
Fortunately, state and federal health reform efforts are placing greater emphasis on social determinants of health, both to improve the health of patient populations and to reduce health care spending. The Health Policy Commission’s Accountable Care Organization (ACO) certification standards include requirements related to addressing social determinants of health. The MassHealth 1115 Demonstration similarly places significant focus on the integration of health-related social services. Likewise, the Centers for Medicare and Medicaid Services (CMS) developed a 10-question screening tool to identify patients’ social service needs; the tool can be used for treatment planning and referrals to community supports.
