Editorial: Early disadvantages can affect health outcomes  



The state’s largest health care systems, along with the Center for Disease Control and Prevention, conduct and publish a community health assessment every three years. The data presented consist of the usual: top health concerns, recent trends and identifying future health priorities. The newest update, released this past week, takes this a step further to include what are known as “social determinants of health.” 

Simply put, social determinants of health are the conditions surrounding one’s life. So, where you live and the conditions under which you are raised also play a role in your health – present and future.  

Examples of social determinants include education, economic stability, health care access, environment and social connectedness. This could include access to healthy food, safe and affordable housing, clean drinking water and stable relationships.  

These social determinants can create disparities that impact vulnerable populations and play a role in health outcomes. They are largely shaped by income and resources, which are not spread evenly across populations. “Differences in health are striking in communities with poor SDOH such as unstable housing, low income, unsafe neighborhoods, or substandard education,” according to the Maine CDC.  

Bottom line: Those who experience disadvantages in childhood are more likely to have poor health outcomes later in life.  

Poverty is considered a prime social determinant of health. Recent data show that nearly 11 percent of individuals and 14 percent of children in Maine live in poverty. Living in poverty makes it difficult to afford quality health insurance, but it also brings with it mental and physical stresses that in turn create their own health challenges. Low-wage workers often do not have access to employer-sponsored health care plans and are more likely to have chronic conditions such as high blood pressure or diabetes or suffer from mental health problems or depression.  

The effects are significant for children living in poverty. According to the Maine Children’s Alliance, growing up in poverty can dramatically influence a child’s life. Poverty can increase a child’s risk for not only poor health but also cognitive, social, emotional and educational impacts.  

Housing insecurity is the third most frequent indicator mentioned. Recent data show that 3 percent of Maine high school students have insecure housing. In many cases, housing insecurity is linked to housing costs. Twelve percent of residents spent more than half of their income on housing in 2019. The cost of housing was the fourth most identified health indicator.  

According to United Health Foundation, social and economic factors more broadly impact an individual or community’s ability to make healthy choices. Therefore, it is imperative that we not only address the actual health of a community but also its well-being.  

Without identifying the most pressing social determinants and charting a course to correct them, we, as a society, will be struggling to fix problems at the surface instead of at the root. When thinking about health, we also have to think of the forces at play behind the scenes and work to address them in a systematic way.  

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