Socioeconomic Determinants of Health

Lifestyle Medicine describes the role health care practitioners and professionals can play in a consultation with a patient or small group to support healthy lifestyle changes.

However, the most effective way to support people to live healthy lives is to provide the opportunity for us to all do this easily. In other words, we need policy makers, government, local councils, employers and public health teams to increase access to healthy food, green spaces, safe places to be active and meet with others, ways to sustain family life, give up smoking and avoid pollution for example. This is why knowledge and action to support the socioeconomic determinants of health form the first principle of lifestyle medicine.

Although clinicians in their consultations can’t easily improve their local environment and social factors at play, we can still use our influence within our communities to push for action to improve these environmental and social factors. There are also plenty of ways to support patients with the wider determinants of health even in a consultation, for example improving access for those with disabilities or barriers to health care, using exercise on prescription, food vouchers, sickness certification, letters to employees, support to seek benefits and so on.

What are the socioeconomic determinants of health?

This short clip by the Health Foundation describes in more detail the importance of social determinants of health.

“The Socio-economic determinants of health are the conditions in which people are born, grow, live, work and age and the fundamental drivers of these conditions”

– WHO Commission on Social Determinants of Health 2005-8

These socio-economic determinants can also be referred to as the “up-stream”, “causes of the causes” or “social determinants of health”.

“We know that health care has far less impact over people’s health than other factors”

– Dr Jennifer Dixon, Chief Executive The Health Foundation

“Health is too important to be left soley to doctors. Health is related not only to access to technical solutions but the nature of society.”

– Professor Michael Marmot, The Health Gap

Evidence suggests that giving simple lifestyle advice, particularly through mass public health education campaigns, often have little impact on lifestyle related behaviours. Lifestyle Medicine takes a different approach from simple advice giving or mass generalised campaigns.

As a discipline, it teaches practitioners to consider the wider factors in people’s lives using a person-centred approach. Individualised behaviour change skills are used in a consultation to help support people to make lifestyle changes, despite the challenges they face.

Lifestyle Medicine is a clinical skill, not a policy tool

Lifestyle Medicine is a clinical skill to be used in one to one or small group settings. Healthcare policy based on an assumption of free choice around lifestyle, risks lack of action to enable everyone to live healthily.

Lifestyle Medicine also uses a person-centred approach, focusing on the needs of the person in front of the practitioner; this includes the social and economic needs of the person.

In a consultation, the option to use lifestyle medicine approaches should be offered to all those who wish to have this support. Some people will need more support than others. Working with population health data can help to identify groups who may need more support.