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Financial health as a measurable social determinant of health
Financial health, understood as one's ability to manage expenses, prepare for and recover from financial shocks, have minimal debt, and ability to build wealth, underlies all facets of daily living such as securing food and paying for housing, yet there is inconsistency in measurement and definition of this critical concept. Most social determinants research and interventions focus on siloed solutions (housing, food, utilities) rather than on a root solution such as financial health. In light of the paucity of public health research on financial health, particularly among low-income populations, this study seeks to: 1) introduce the construct of financial health into the domain of public health as a useful root term that underlies other individual measures of economic hardship and 2) demonstrate through outcomes on financial, physical and mental health among low-income caregivers of young children that the construct of financial health belongs in the canon of social determinants of health.
In order to extract features of financial health relevant to overall well-being, principal components analysis were used to assess survey data on banking and personal finances among caregivers of young children who participate in public assistance. Then, a series of logistic regressions were utilized to examine the relationship between components of financial health, depression and self-rated health.
Components aligned with other measures of financial health in the literature, and there were strong associations between financial health and health outcomes.
Financial health can be conceived of and measured as a key social determinant of health.
Journal Article
Contextual nonmedical health factors and critical care-related outcomes: a systematic review
Background
Disparities in non-medical health factors, such as social determinants of health (SDoH), are associated with increased risk of negative health outcomes. Leveraging contextual (or area-based) measures of SDoH is essential for uncovering broader factors influencing disparities in critical care-related outcomes. Our objective is to review evidence analyzing the association between contextual SDoH obtained from publicly available databases and critical care-related outcomes in the United States (US).
Methods
We conducted searches in the Web of Science, PubMed, Cochrane, and Embase electronic database to obtain clinical studies utilizing SDoH datasets from publicly available data sources and analyzed these studies for associations between critical care-related outcomes and SDoH (search date June 8th, 2025). We excluded non-English articles, reviews, editorial commentaries, letters to editors, studies without intensive care unit (ICU) patients or SDoH variables, studies based on countries outside of the US and studies that lacked full text or contained only the abstract. We extracted cohort characteristics, SDoH measures and domains, SDOH database characteristics, ICU admissions and outcomes, analytical method used for determining the association between SDoH and ICU variables, and significant SDoH variables.
Results
We identified 87 publications (44 with pediatric patients, 40 with adult patients, and 3 with a mixture of both) and study population characteristics (e.g., surgical or specific disease-diagnosed patients). Child Opportunity Index and American Community Survey were the top platforms utilized for acquiring SDoH in pediatric and adult cohorts, respectively, followed by Area Deprivation Index and Social Vulnerability Index in both cohort types. Area-level granularity included boundaries determined by counties, ZIP codes, census block groups and census tracts.
Conclusions
Among five SDoH domains, economic stability was found to be the top investigated SDoH category for critical care-related outcomes. Contextual SDoH variables, indicating more vulnerable and adverse conditions, were associated with higher ICU admissions, greater need for ICU resource utilization, longer ICU duration, higher likelihood of developing critical illnesses, worsened life quality following ICU discharge, and higher mortality. Social determinants of health offer a broad area for modifiable intervention targets. Public databases serve as facilitators towards SDoH integration into electronic health records, promoting value-based care and mitigating health inequities.
Journal Article
Covid-19 pandemic and the social determinants of health
Lauren Paremoer and colleagues call for action to create a fairer and more sustainable post-covid world
Journal Article
Epidemic exposure : the rich flee and the poor take the bus
\"This work provides a look at health and economic inequality in pandemics\"-- Provided by publisher.
Book
Social Determinants of Mental Health: Where We Are and Where We Need to Go
Purpose of Review
The present review synthesizes recent literature on social determinants and mental health outcomes and provides recommendations for how to advance the field. We summarize current studies related to changes in the conceptualization of social determinants, how social determinants impact mental health, what we have learned from social determinant interventions, and new methods to collect, use, and analyze social determinant data.
Recent Findings
Recent research has increasingly focused on interactions between multiple social determinants, interventions to address upstream causes of mental health challenges, and use of simulation models to represent complex systems. However, methodological challenges and inconsistent findings prevent a definitive understanding of which social determinants should be addressed to improve mental health, and within what populations these interventions may be most effective.
Summary
Recent advances in strategies to collect, evaluate, and analyze social determinants suggest the potential to better appraise their impact and to implement relevant interventions.
Journal Article
Crisis averted : the hidden science of fighting outbreaks
\"A fascinating window into the secret life of epidemiology, weaving together stories of triumph and tragedy, with a boots-on-the-ground perspective on how we can avert the next public health crisis There are few visible markers of the accomplishments of public health. If epidemiologists do their jobs, nothing happens. An outbreak does not grow into an epidemic. A child does not go hungry. A would-be smoker never lights up. These achievements are rarely noticed or celebrated, but Caitlin Rivers lives for such victories. By making sure that things don't happen, she and legions of scientists, practitioners, and policymakers change the course of history. We have many of the tools and experiences needed to prevent the next crisis, but countless challenges remain, including constantly emerging pathogens, the rapid growth of biotechnology, and the inconsistent cycles of funding for government organizations like the CDC. Progress can be slow, even with the next pandemic potentially right around the corner, but the unsung heroes in public health remain focused on their missions. Crisis Averted is their story-from the eradication of smallpox in the 20th century to today's safeguards against extraterrestrial germs. By taking a candid look at how we solve problems in public health, Caitlin Rivers illuminates the role of epidemiology in all our lives and lays out the case for what can be accomplished, given sufficient vision, leadership, and resources. Crisis Averted is an inspiring and galvanizing clarion call for us to work together towards a healthier, more resilient future\"-- Provided by publisher.
BOOK
The health gap: the challenge of an unequal world
Relieving adult poverty, paying a living wage, reduction in fuel poverty, improving working conditions, improving neighbourhoods, and taking steps to reduce social isolation in elderly people can save lives.1 The health gradient to which these life course influences give rise is dramatic.
Journal Article