HEALTH
Social Spotlight
COVID-19 reveals outside health factors by Karen A. Jamrog
I
n some ways, health is like real estate: Location matters. Probably more than any event in recent memory, COVID-19 has highlighted the relationship between people’s health and their address, along with other factors known as the “social determinants of health.” We’re not talking just about wealth or whether you live in a grand manse or swank neighborhood. Social determinants encompass whether your neighborhood is safe and well-designed with sidewalks; whether you have access to transportation, healthful food, clean air and water, medical care, education and employment that provides a living wage; your race and more. “The social determinants of health really
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focus on the fact that just going to the doctor doesn’t really determine how well you are. It’s the community in which you live and work and play,” and it’s about accessibility, says Patricia M. Tilley, MS Ed., deputy director of the New Hampshire Division
of Public Health Services, Department of Health and Human Services. “Your zip code,” Tilley says, “may determine more about your health than almost anything about you.” Social determinants include a range of physical as well as social factors — how much social support you have, for example, whether you suffer from discrimination, how much stress you experience, but also how much green space is near you, whether you’re exposed to toxic substances, and whether you live in safe housing. Research indicates that social factors and physical environment together account for about 50% of people’s health status, says Semra Aytur, PhD, MPH, an associate professor in the Department of Health Management and Policy at the University of New Hampshire. Behavior such as eating habits, the ability to exercise and substance misuse, which are greatly influenced by social and physical environmental factors, account for another 30%. After adding those elements together, Aytur says, “we have accounted for over 80% of a population’s health status without even [considering] genetics or medical care.” While COVID-19 has affected all of us “in profound ways,” Tilley says, it has hit some communities — particularly lower-income individuals — harder than others, reflecting the significance of, among other things, social determinants of health. People who live in low-income com-
“Your zip code may determine more about your health than almost anything about you.” — Patricia M. Tilley, MS Ed.
illustration by gloria diianni
603 LIVING
