Socioeconomic status, or SES, is a combined measure of economic, social, and work factors. An individual’s SES is based on aspects of their economic and social position, such as income, education, and occupation. SES status has been shown to significantly affect our health. In fact, the social and economic conditions that we live in are considered to have the largest impact on health, accounting for 40% of predicted health outcomes.

Robert Wood Johnson Foundation (RWJ) and the Population Health Institute at the University of Wisconsin based their annual "County Health Rankings Report” on this research.

Social determinants of health include the conditions in which people are born, grow, live and work. These social and economic systems we live in are shaped by the distribution of money, power, and resources at both local and global scales. According to the World Health Organization, social determinants of health, such as level of education, income, social support, and community safety, are primarily responsible for health inequalities. Health inequalities are unfair differences in health status experienced by certain populations. For example, there is a correlation between people with a lower SES and higher risk for chronic disease and higher mortality rates. Such health inequalities also exist between different genders and different ethnic groups.

Robert Wood Johnson Foundation Research:

The RWJ Foundation provides some great information and background into the research related to social determinants of health in the webinar, “What Shapes Health?” For additional information, RWJ created in-depth briefs on key social determinants of health. Three main factors include:

1. Social Factors:  Research is showing connections between education, income, race, and living and working conditions on health:
   1. Income and wealth shape access to health-promoting conditions, such as the resources to purchase fruits and vegetables, living in neighborhoods with full-service supermarkets, and safe neighborhoods with places to exercise. Higher income has been linked with better health and longer life spans among adults. For example, adults in the highest income bracket have been shown to live, on average, six years longer than adults in the lower income brackets (p.5).
   2. Education plays a powerful role in shaping health behaviors, in multiple ways. Education level is linked to employment and income opportunities, greater health knowledge, better problem-solving skills to make more informed health choices, and links into social support systems and norm groups that support healthy behavioral choices (1).
2. Stress:  Research is showing a connection between exposure to chronic stress and negative health outcomes:
   1. Exposure to stress affects the neuroendocrine system, which in turn affects the regulation and aging of the immune system and metabolic changes that contribute to cardiovascular disease (p.3).
   2. Exposure to stress affects the sympathetic nervous system, in turn, raising blood pressure and heart rates (p.3).
   3. Exposure to stress impacts the immune systems, the body’s main defense against infections (p.3).
3. Early Childhood Experiences:  This research focuses on the critical role this period of early development plays on shaping the foundation for lifelong health. This information is associated with the Adverse Childhood Experiences (ACE) Study:
   1. “Children’s social and economic conditions have direct affects on health. Low-income/low educational level mothers are more likely to have premature or low birth rate babies. These babies are more likely to experience more health risks throughout their lifetime. In addition, family income levels impact nutrition, housing and community safety opportunities, all of which directly affect children’s health” (p.2).
   2. “Children’s development shapes health throughout life. Brain, cognitive and behavioral development early in life are strongly linked to important health outcomes later in life, including cardiovascular disease and stroke, hypertension, diabetes, obesity, smoking, drug use and depression “ (p.4).