SDOH Is More Than a Catchphrase

Allison Barkel
7 days ago
4 min read

If you’re a social services professional, chances are you’ve heard of the phrase “SDOH” or Social Determinants of Health. SDOH has become a catch-all phrase that loosely references barriers to health, which in a lot of ways, is correct. However, SDOH is much more complicated and critical to understanding the needs of the most vulnerable members of our communities. While the statistics and references included here are primarily focused on Indiana, SDOH barriers are relevant to all communities and sub populations throughout the country.

So where do we start? To begin, let’s start with the Healthy People 2030 definition, “Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Healthy People 2030 leverages five domains that we will use to guide our examples:

Economic Stability

Medicaid eligibility, depending on circumstances, is usually determined based on the federal poverty line (FPL). For 2026 the FPL is a yearly income of $15,960 for an individual, with the amount increasing slightly depending on the number of people in the family. Now imagine yourself living at the FPL as an individual - you would have to significantly adjust your standard of living, which would more than likely include choices that impact your health. This sacrifice may include choosing between fresh fruits and vegetables, prescription choices, or safe housing options. The goal for this SDOH domain is “help people earn steady incomes that allow them to meet their health needs (Healthy People 2030).”

Education Access & Quality

Several years ago I was a regular volunteer at Indy Reads. As part of our orientation, we were asked to imagine all of the things we read every single day - receipts, road signs, product directions, prescription bottles, and just books for personal enjoyment or education. It dawned on me how lucky I was to be able to read, and thanks to my education background, actually understand what I am reading. The challenges faced by people who cannot read or understand what they are reading can result in fewer workforce and employment opportunities, higher incarceration rates, and poor health outcomes. By increasing education and literacy rates, we begin to break cycles of poverty, increase health literacy, and quality of life for individuals and their families.

Health Care Quality & Access

At the crux of good health, is the ability to get good, reliable health care. Whether you’re from the most rural part of Indiana or downtown Indianapolis, there are barriers to access across the state including lack of transportation, access to specialists, and affordability. In addition, most of Healthy People 2030’s objectives relate to preventative care which adds another layer of difficulty depending on people’s health literacy, negative experiences within the health care systems, access to health care insurance, or work schedules that make it difficult to accommodate healthcare appointments.

Neighborhood and Built Environment

Perhaps the greatest examples of health impacts outside of one’s personal choices and genetics is the neighborhood and built environment domain. This domain includes many factors including whether someone has access to clean drinking water or if they have clean, toxin-free air to breathe. This can also include the ability to safely use a bike, access mass transportation, or have exposure to smoking either at home or in the workplace. These environmental exposures can lead to asthma, vehicle crashes or lead exposure resulting in short-term or long-term health conditions.

Social and Community Context

When we think of the important people in our lives, they all have a lot of influence on our decisions and our comfortability sharing our needs, concerns, and life updates. According to the CDC, 3 in 4 high schoolers experience one or more adverse childhood experience (ACE), which includes abuse, neglect, and/or household dysfunction. These childhood experiences can result in huge impacts as an adult, including a reduction in life space expectancy, increase in substance use, increase in chronic disease, and increased risky sexual behaviors. Having a safe, attentive, and stable household growing up can be the key difference in how you navigate and thrive in the world as an adult.

So next time you’re considering why individuals or communities have different health outcomes, or why someone has been resistant to get the care that they need, remember it’s so much more complicated than that. The Social Determinants of Health (SDOH) provide an understanding of the landscape of the why, but it’s up to all of us to think critically about the how. How do we make our community health more equitable and accessible?

Allison Barkel serves as an Engagement Manager for Summit Managed Solutions. With a background in human resources, education and program management, Allison is proud to lead a team of amazing Summit team members while also helping partners remove barriers to access community resources and quality health care. She is also heavily involved in the Indianapolis community with a dedication to making Indiana a place where all Hoosiers can thrive. In her free time, Allison likes to explore Indy Parks with her partner and dog, go on travel adventures with family and friends, and relax by curling up with a good book.

Summit Managed Solutions is a management consulting and professional services firm that partners with healthcare organizations across the private, public, and social sectors to create value. By providing comprehensive solution management and inclusive business operation services, Summit helps deliver specific, transformative outcomes. With consulting and managed service offerings, Summit helps partners overcome the critical challenges associated with people, process, and technology, while providing partners with flexibility, reliability, and innovation that will propel growth.