An open source visualization of the social determinants of health.

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The 5 main determinants of health (genetics, medical care, social circumstances, environment, and individual behavior) were chosen due to their consistency across the following 7 out of 8 organizations:

NCHHSTP [1]
WHO [2]
Healthy People [3]
Kaiser Family Foundation [4]
NEJM [5]
Health Affairs [6]
Institute of Medicine [7]
New South Wales Department of Health [8]

The 29 macrodeterminants and 66 microdeterminants below each main category were found by compiling the determinant lists of the previously mentioned organizations.

The section below documents our analysis of the data and how we calculated the final impact percentages for the 5 main categories of determinants.

The relative contribution of each of the determinant categories to one’s health was found using the estimated values referenced by the seven primary sources listed below.

DHHS [9]
JAMA [10, 12]
Health Affairs [11]
PLoS [13]
WHO [14]
U.Wisconsin [15]

Each determinant category was then averaged based on the values from each of the aforementioned sources (the methodology in the primary sources were different depending on the source. The final percentages should therefore be an estimate and not be viewed as absolute numbers).

Behavior: (50 + 38 + 40 + 39 + 36 + 45 + 30) / 6 = 46.33.

Social: (15 + 40) / 2 = 27.5.

Genetics: (20 + 30) / 2 = 25.

Medical care: (10 + 10 + 20) / 3 = 13.33.

Environment: (20 + 7 + 5 + 5.4 + 3 + 10) / 6 = 8.4.

The ratio for each determinant was then found by taking the average values found for each of the determinant categories and dividing them by the total determinant value.

Behavior: 46.33 / 120.56 = 38.43%.

Social: 27.5 / 120.56 = 22.81%.

Genetics: 25 / 120.56 = 20.74%.

Medical care: 13.33 / 120.56 = 11.06%.

Environment: 8.4 / 120.56 = 7%.

Total: 38.43 + 22.81 + 20.74 + 7 + 11.06 = 100.4%.

The final percentages are as follows.

Behavioral determinants at 38%.

Social determinants at 23%.

Genetic determinants at 21%.

Medical care determinants at 11%.

Environmental determinants at 7%.

Health Determinants digital service is Apache 2.0 licensed.

The Health Determinants content and poster is licensed under Creative Commons Attribution v4. If you want to reference this work (in a paper, for example), feel free to use:

Choi, Edwin, and Juhan Sonin. 2019. “Determinants of Health.” GoInvo. https://www.goinvo.com/vision/determinants-of-health/.