Health is shaped by more than just medical care—it is deeply influenced by our surroundings and opportunities. The Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age, impacting overall well-being. They include

• Economic Stability – Access to stable jobs, income, and financial resources affects a person’s ability to afford healthcare and necessities.

• Education Access & Quality – Higher education levels are linked to better health outcomes, emphasizing the importance of accessible quality education.

• Health Care Access & Quality – Having affordable, reliable healthcare determines how well individuals can prevent or manage illnesses.

• Neighborhood & Built Environment – Safe housing, clean air, and access to nutritious food all contribute to a healthier life.

• Social & Community Context – Support systems, community engagement, and discrimination impact emotional and physical health

Health is more than just access to medical care—it is shaped by the environment and social conditions in which people live. The Social Determinants of Health (SDOH) are non-medical factors that significantly impact overall well-being and health outcomes.

This concept is crucial because it highlights that factors such as economic stability, education, healthcare access, neighborhood conditions, and social support play an essential role in determining how healthy individuals and communities can be. Addressing SDOH is key to achieving health equity, ensuring that everyone, regardless of background, has the opportunity to lead a healthy life.

By prioritizing SDOH, we can build stronger, healthier communities and reduce disparities in healthcare access.

Health is shaped social and environmental factors. According to research, 80% of health outcomes are influenced by non-medical factors, such as economic stability, education, and social environments, while only 20% are directly linked to clinical care. The 5 key areas that contribute to health outcomes include

• Behavioral Factors (36%) – Lifestyle choices such as diet, exercise, and smoking have the greatest influence.

• Social & Economic Factors (24%) – Income, education, and social connections shape opportunities for good health.

• Genetics (22%) – Genetic predispositions impact health risks.

• Clinical Care (11%) – Access to quality healthcare plays a role, but is not the most significant factor.

• Environmental Factors (7%) – Housing conditions, air quality, and access to healthy foods influence well-being.

• Education 📚 – Higher education improves health literacy, leading to better decision-making and access to healthcare.

• Income 💰 – Financial stability allows for better healthcare, nutrition, and living conditions, reducing health risks.

• Housing 🏡 – Safe, stable housing minimizes exposure to environmental hazards and stress-related health issues.

• Access to Care 🏥 – Timely, affordable healthcare prevents disease progression and improves long-term wellness.

• Social Support 🤝 – Strong community ties enhance mental health, reduce stress, and encourage healthy behaviors.

Addressing these factors improves health equity and overall well-being.

Food insecurity—the lack of consistent access to enough nutritious food for an active, healthy life—is a growing public health concern that directly impacts clinical outcomes. It is especially relevant for patients with chronic conditions and Disorders of Gut-Brain Interaction (DGBIs) such as irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain.

This visual resource outlines key drivers of food insecurity including poverty, high food prices, and limited access to full-service grocery stores. As healthcare professionals, we are in a pivotal position to identify and address food insecurity during routine care.

🔍 What You Can Do in Clinical Practice:

• Screen for food insecurity using validated tools such as the Hunger Vital Sign, a two-question screening tool based on the U.S. Household Food Security Scale.

• Connect patients to local and national nutrition support programs, including:

• SNAP: Supplemental Nutrition Assistance Program

• WIC: Special Supplemental Nutrition Program for Women, Infants, and Children

• Local food banks, community meals, and produce prescription programs

• Partner with and support community food banks and charitable food organizations to build referral networks and improve access.

• Advocate for policy and systems changes that promote equitable access to affordable, healthy food—especially in under-resourced neighborhoods and for medically vulnerable populations.

Food insecurity can significantly worsen outcomes for individuals living with Disorders of Gut-Brain Interaction (DGBIs), such as irritable bowel syndrome (IBS), functional dyspepsia, and functional abdominal pain. There are four core ways food insecurity affects DGBI patients:

🔺 Increased GI Symptoms

Poor diet quality and irregular eating patterns—often driven by limited food access—can amplify GI symptoms like pain, bloating, and altered bowel habits.

🍽️ Nutritional Triggers

Patients may struggle to afford low-FODMAP or symptom-friendly foods, or be unable to adhere to therapeutic diets due to budget or access limitations.

😟 Psychological Stress

Worry about food availability adds emotional distress, which is known to worsen visceral sensitivity and symptom severity through the gut-brain axis.

📉 Reduced Treatment Response

Patients facing food insecurity may be unable to prioritize healthcare or gain the full benefit of nutrition-based treatment recommendations, making management less effective.

What You Can Do:

• Routinely screen for food insecurity in patients with DGBIs.

• Refer to nutrition support services, food banks, or social workers when needed.

• Tailor dietary recommendations to be practical, realistic, and sensitive to resource limitations