Social Determinants of Health

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For more than a decade, Cigna has worked to address and eliminate disparities in health care. Recently, we received our fourth Innovation in Advancing Health Equity Award from the National Business Group on Health.

Social determinants of health (SDOH) are conditions in the places where people are born, live, learn, work, play, worship, and age that affect a wide range of health risks and outcomes. These determinants generally show that:

  • Poverty limits access to healthy foods and safe neighborhoods.
  • The level of education is a predictor of better health.
  • Differences in health are striking in communities with poor SDOH, such as unstable housing, low income, unsafe neighborhoods, or substandard education.
  • By applying what we know about SDOH, we can improve individual and population health while also advancing health equity.
A young child reaches for a bar at the playground

While there are many social determinants of health, the factors are commonly grouped into five main categories:


The actual place an individual lives is their neighborhood. These places include factors such as crime and violence rates, the quality of housing and infrastructure, access to ample and nutritious foods, and various other environmental considerations.

Health and Health Care

Levels of health literacy, access to primary care and specialists, and access to health care in general all relate to a person's health.

Social and Community Context

People's community and social support system includes their level of civic participation, whether they face or have faced discrimination, whether they are or have ever been incarcerated, and the degree of social cohesion in their communities.


Education considers early childhood education and development, up-to-date textbooks and course materials, student-to-teacher ratios, educational outcomes, as well as language skills and literacy, high school graduation rates, enrollment rates in higher education, and learning throughout a people’s lifetime.

Economic Stability

Economic factors that may impact health outcomes include employment rates, poverty levels, food insecurity, and housing instability.

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