Are social determinants of health actually determinants?

There has obviously been a tremendous proliferation of research on what has long been labeled “social determinants of health.” The wording, however, is unfortunate. “Determinants” suggests determinism–a mechanistic set of influences that do not allow for the possible, for the stochastic, for the undetermined. The problem with “social determinants of health” is that it is too–deterministic. This is an irony. We cannot treat social factors such as locus of control, inequality, and structural violence as though they are deterministic variables in simple Newtonian mechanics. The irony is great. I now use “social influences on health” as a simple substitute. We need new words. Language can determine how we think.


About epihealth

Professor Emeritus of Epidemiology and Medical Geography, University of Washington, Seattle. Formerly Adjunct Prof, Depts of Medicine (Div of Infectious Diseases), Family Medicine, Health Services, and Global Health. President, Health Improvement and Promotion Alliance-Ghana Expertise in infectious diseases, epidemiology and clinical epidemiology, epi. of pain, community health, travel medicine, tuberculosis, disease control.
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