Australian Institute of Health and Welfare (2022) Social determinants of health, AIHW, Australian Government, accessed 03 February 2023.
Australian Institute of Health and Welfare. (2022). Social determinants of health. Retrieved from https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health
Social determinants of health. Australian Institute of Health and Welfare, 07 July 2022, https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health
Australian Institute of Health and Welfare. Social determinants of health [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2023 Feb. 3]. Available from: https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health
Australian Institute of Health and Welfare (AIHW) 2022, Social determinants of health, viewed 3 February 2023, https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health
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Evidence supports the close relationship between people’s health and the living and working conditions which form their social environment (Baum 2018; Wilkinson and Marmot 2003). Factors such as socioeconomic position, conditions of employment, the distribution of wealth, empowerment and social support – known collectively as the social determinants of health – act together to strengthen or undermine the health of individuals and communities.
The World Health Organization (WHO) describes social determinants as ‘the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems’ (Senate Standing Committees on Community Affairs 2013; WHO 2022).
Social determinants form part of the wider determinants of health which also include the environmental, structural, economic, cultural, biomedical, commercial and digital factors in our lives (Department of Health 2021).
According to the WHO, the social determinants of health have an important influence on health inequities – the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income – including Australia – health and illness follow a social gradient: the lower the socioeconomic position, the worse the health (WHO 2022). See Health across socioeconomic groups.
Future analysis of integrated (linked) data has the potential to provide further insights into the complex links between social determinants of health and outcomes, and greater evidence for causal pathways to good health.
This page provides selected data to monitor key social determinants of health in Australia.
‘Social determinants of health’ has rapidly become a central concept in population and public health, leading to the emergence of new theoretical models and frameworks.
Although there is no single definition of the social determinants of health, there are common usages across government and non-government organisations.
The WHO lists the following as social determinants which can influence health equity in positive and negative ways:
In general, every step up the socioeconomic ladder is accompanied by a benefit for health (see Health across socioeconomic groups). The relationship is two-way – poor health can be both a product of, and contribute to, lower socioeconomic position.
Socioeconomic position is often described through indicators such as educational attainment, income or level of occupation.
This Tableau dashboard shows recent trends in 3 key social determinants of health – education, unemployment and income.
In 2021, 68% of people aged 25–64 held a non-school qualification at Certificate III level or above, an increase of 20 percentage points since 2004.
The foundations of adult health are laid in-utero and during the early childhood period. The different domains of early childhood development – physical, social/emotional and language/cognition – strongly influence school success, economic participation, social citizenship and health (van Eyck et al. 2021).
An individual’s family can influence physical and mental health in a number of ways, including through creating a safe and supportive emotional and learning environment, and through providing access to services, products and activities.
As with other health determinants, the effects follow a continuum from potential benefit in positively functioning and supportive families to potential disadvantage in families with abuse or neglect.
Social connectedness and the degree to which individuals form close bonds with others outside the family has been linked in some studies to lower morbidity and increased life expectancy. Strong social networks may benefit physical and mental health through practical and emotional help and support, and through networks that help people find work or cope with economic and material hardship. See Social isolation and loneliness.
Social exclusion is a term that describes social disadvantage and lack of resources, opportunity, participation and skills which are essential for full participation in society (See Glossary). Social exclusion through discrimination or stigmatisation can cause psychological damage and harm health through long-term stress and anxiety. Poor health can also lead to social exclusion.
The psychosocial stress caused by unemployment has a strong impact on physical and mental health and wellbeing. Once employed, participating in quality work helps to protect health, instilling self-esteem and a positive sense of identity, while providing the opportunity for social interaction and personal development.
See Employment and unemployment.
Access to appropriate, affordable and secure housing can limit the physical and mental health risks presented by factors such as homelessness and overcrowding.
Evidence also supports a direct association between poor-quality housing and poor physical and mental health (Baker et al. 2016). Young people, Aboriginal and Torres Strait Islander people, people with long-term health conditions or disability, people living in low-income housing, or people who are unemployed or underemployed are at greater risk of living in poor-quality housing.
This Tableau dashboard shows recent trends in 2 key social determinants of health – housing and homelessness.
The rate of homelessness has changed from 51 per 10,000 population in 2001, to 45 per 10,000 population in 2006, 48 per 10,000 in 2011 and 50 per 10,000 population in 2016.
Evidence has shown that infection, hospitalisation and mortality among some population groups have been disproportionally affected by the COVID-19 pandemic, making the impact one of inequality (WHO 2021). The impact extends to the social determinants of health, with adverse effects on income, education, employment, and housing more pronounced among lower socioeconomic groups. These effects can then act to worsen health inequities.
Evidence has also shown there has been an increase in psychological distress during the COVID-19 pandemic, which may be associated with social inclusion and loneliness (AIHW 2022).
See 'Chapter 2 Changes in the health of Australians during the COVID-19 period' in Australia’s health 2022: data insights.
For more information on social determinants of health, see:
ABS (Australian Bureau of Statistics) (2018) Census of Population and Housing: estimating homelessness, 2016, ABS, Australian Government, accessed 19 February 2022.
ABS (2019a) Household income and wealth, Australia, 2017–18, ABS, Australian Government, accessed 19 February 2022.
ABS (2019b) Housing occupancy and costs, 2017–18, ABS, Australian Government, accessed 19 February 2022.
ABS (2021a) Education and work, Australia, May 2021, ABS, Australian Government, accessed 19 February 2022.
ABS (2021b) Labour force status of families, June 2021, ABS, Australian Government, accessed 19 February 2022.
ABS (2021c) Microdata: Preschool education, Australia, 2020, ABS, Australian Government.
ABS (2021d) Preschool education, Australia, 2020, ABS, Australian Government, accessed 19 February 2022.
ABS (2022a) Employee earnings and hours, Australia, May 2021, ABS, Australian Government, accessed 19 February 2022.
ABS (2022b) Labour force, Australia, March 2022, ABS, Australian Government, accessed 26 April 2022.
AIHW (Australian Institute of Health and Welfare) (2018) Indicators of Australia’s health: proportion of people with low income, in Australia’s health 2018, AIHW, Australian Government, accessed 19 February 2022.
AIHW (2019a) Family, domestic and sexual violence in Australia: continuing the national story 2019, AIHW, Australian Government, accessed 19 February 2022.
AIHW (2019b) National Social Housing Survey 2018: key results, AIHW, Australian Government, accessed 19 February 2022.
AIHW (2020) Australia’s children, AIHW, Australian Government, accessed 19 February 2022.
AIHW (2021a) Determinants of wellbeing: Social connection, AIHW, Australian Government, accessed 19 February 2022.
AIHW (2021b) National framework for protecting Australia's children indicators, AIHW, Australian Government, accessed 19 February 2022.
AIHW (2022) The use of mental health services, psychological distress, loneliness, suicide, ambulance attendances and COVID-19, AIHW, Australian Government, accessed 22 April 2022.
Baker E, Lester LH, Bentley R and Beer A (2016) ‘Poor housing quality: prevalence and health effects’, Journal of Prevention & Intervention in the Community, 44:219–232, doi:10.1080/10852352.2016.1197714
Baum F (2018) ‘People’s health and the social determinants of health’, Health Promotion Journal of Australia, 29:8–9, doi:10.1002/hpja.498.
Brotherhood of St Laurence and MIAESR (Melbourne Institute of Applied Economic and Social Research) (2020) Social exclusion monitor, Brotherhood of St Laurence, Melbourne.
Department of Health (2021) National Preventive Health Strategy 2021–2030, Department of Health, Australian Government, accessed 4 March 2022.
Senate Standing Committees on Community Affairs (2013) Australia's domestic response to the World Health Organization's (WHO) Commission on Social Determinants of Health Report “Closing the gap within a generation”, Australian Government, accessed 1 March 2022.
van Eyck H, Baum F, Fisher M, MacDougall C and Lawless A (2021) ‘To what extent does early childhood education policy in Australia recognise and propose action on the social determinants of health and health equity?’, Journal of Social Policy, First view, 1-25, doi:10.1017/S0047279421000726.
WHO (World Health Organization) (2021) COVID-19 and the social determinants of health and health equity: evidence brief, WHO, Geneva, accessed 1 March 2022.
WHO (2022) Social determinants of health, WHO, Geneva, accessed 17 January 2022.
Wilkinson R and Marmot M (eds) (2003) The social determinants of health. The solid facts, 2nd edn, WHO Europe, Copenhagen, accessed 1 March 2022.
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