At Access Elemental Social Prescribing, we know the pressure that is on GPs to support all their patients’ needs and how the demand is getting more difficult to manage.

We want to reduce that pressure by highlighting the importance of digital social prescribing to reduce the health inequalities across your community.

This article will review the wider social determinants of health, provide examples of how they affect mental health and wellbeing, and discuss the methods used to address the determinants of health by explaining how social prescribing reduces health inequalities to improve the overall health and wellbeing of your local area.

What are the social determinants of health?

Social determinants of health can be defined in several different ways.

The World Health Organsiation defines a social determinant of health as a non-clinical factor that influences health outcomes. The UK Government defines them as the broad and social circumstances that influence the health of individuals across their lifespan.

These are the conditions in which people are born, grow, work, live, and age which shape the conditions of daily life and are responsible for the health inequities seen both nationally and globally.

They have an important influence on health inequalities across communities and are part of a social gradient where individuals from more socially deprived areas tend to experience the worst health outcomes compared to individuals who are financially better off.

Sometimes referred to as the social factors of health and social care, there are many different health determinants an individual can experience at the same time providing both positive and negative impacts.

Social determinants of health examples

Many determinants and factors can affect someone’s mental health and wellbeing. Here these social determinants of health can influence health equities in both positive and negative ways and these include:

• Income and social protection
• Education
• Unemployment and job security
• Working life conditions
• Food insecurity
• Housing, basic amenities, and the environment
• Early childhood development
• Social inclusion and non-discrimination
• Structural conflict
• Access to healthcare

Despite there being many determinants of health it is important to note there are 5 main examples that often then cause further determinants for individuals to experience.

1. Education

Education is an example of a key wider determinant of health as it has a long-term impact on both employment and wellbeing.

The National Office for Statistics states in England only a 1/3 of children eligible for free school meals do well at their GCSEs. So, if individuals have a poor education or little education their chances of obtaining well-paid employment are low which in the long term can cause mental health issues including depression.

Equally, education can also cause mental health issues such as stress and anxiety. Within higher education and university, many students can drop out of university for many reasons some of them being either they are finding their course too difficult to navigate or manage or they don’t have access to the resources they need. This, in turn, can cause student mental health and wellbeing to reduce, university dropouts to increase, and students left depressed, stressed, or feeling like a failure.

2. Housing

Another key social determinant of health is housing. Having poor housing conditions is heavily associated with several health problems such as respiratory conditions including asthma, but it also can cause mental health issues.

Private renting has increased significantly over the last 20 years leading to the living standards in rented accommodations to differ massively. This, in turn, can lead to individuals paying increasingly high amounts in rent in poor-quality housing leaving tenants stressed and worried about how they will pay for other things including gas, electricity, and food.

It was projected that in 2023, fuel poverty would increase to 14.4% across the UK accounting for 3.53 million people struggling to afford their pay their bills. This, in turn, can heighten anxiety and stress in residents leaving tenants depressed because of their housing issues.

3. Economic Stability

Arguably one of the biggest determinants of health is being economically stable. This is because financial resources directly impact access to housing, education, nutrition, and sometimes healthcare, as well as other essential resources that influence an individual’s health and wellbeing.

If someone is unemployed for a significantly long period, they are more likely to suffer from mental health issues such as anxiety, and depression, as well as have a lower life expectancy and poorer health than someone who is in stable employment.

4. Healthcare Access

Healthcare access is a critical social determinant of health because it directly influences an individual’s ability to obtain timely care and support.

Health inequalities are either the differences in health status or the distribution of health determinants between different population groups.

In England on average, the difference in disability-free life experience expectancies between richer and poorer parts of the country is 17 years. In Scotland, individuals living in more socially deprived areas have on average a lower life expectancy of 11 years compared to those living in less socially deprived areas.

5. Social Communities

Social communities are an important social determinant of health inequalities because they shape an individual’s social connections, support networks, and access to resources that influence health outcomes.

As discussed above, living in more socially deprived areas can lead to poorer mental health and wellbeing as well as higher exposure to anti-social behaviour and a lack of cohesion and participation in the community.

Discrimination in the workplace, a lack of social norms, and social acceptance can all happen regardless of where you live. However, the severity and frequency of experiencing these issues can differ depending on where you live in the country.

In general, The World Health Organisation has stated the lower the socioeconomic status the worse their overall health will be. The gap between the rich and the poor has continued to widen in the UK and areas of social deprivation tend to suffer more from the social determinants of health because of this.

The social determinants of health – how has the cost-of-living crisis affected them?

The cost-of-living crisis has had significant impacts of the wider determinants of health affecting various aspects of individual’s lives and overall wellbeing including both housing and food insecurity, and employment insecurities for some.

With these financial stressors we have seen a massive rise in both the number of people using foodbanks and fuelbanks, with over 8 million people using foodbanks alone in 2023.

In May 2022 Michael Marmont stated that the cost-of-living crisis has and will cause a direct impact on physical and mental health. Some people have been left with making impossible decisions about whether to eat or whether to warm their homes and these difficult decisions are negatively impacting individual’s mental health and wellbeing.

The NHS confederation also has made an unprecedented move on behalf of NHS leaders to warn a pending public health crisis as the impact of the cost of living and the pandemic is putting unsustainable pressure on households, individuals, and the NHS alike.

The unprecedented times over the last four years have most likely impacted us all in some way or another. It is not a coincidence then that health, social care, and other public services continue to experience pressures and increased waiting times as more and more people are seeking help and support.

Determinants of Health model – what is it and how can it help?

To overcome the wider social determinants of health various different models and plans have been put into place to reduce health disparities and address how social factors can impact an individual’s health and wellbeing.

The Health and Care Act 2022 established a system-based model of health and care to introduce the opportunities for organisations and stakeholders to work together and create multidisciplinary teams that focuses on what matters to individual to bridge the gap between support across health and social care.

The NHS Long Term Plan declared an increased movement in shared decision-making between patients and clinicians to achieve more patient centred care, as well as more funding to upscale non-clinical support across the country.

This increased funding has allowed social prescribing to grow massively and allow Social Prescribing Link Workers to work with patients to refer them to the community-based interventions to best suit the support they require to improve their mental health and wellbeing.

Here these models highlight the importance of the VSFSE sector sharing knowledge and experiences across organisations holistically  to overcome the wider social determinants of health.

Social Prescribing Social Determinants of health – why is it important?

At Access Elemental Social Prescribing we work with a wide range of different social prescribing projects and services to successfully produce outcomes that overcome the wider social determinants of health.

We know and understand the different social factors that can impact an individual’s wellbeing and work with lots of organisations across many sectors to help build stronger multidisciplinary teams that concentrate on what’s important, the individual.

Through offering safe and assured pathways we help reduce workloads and pressure on primary care by offering a more sophisticated and easier way to make, manage, and track referrals.

SPRING Social Prescribing is one our longest customers. They work with 154 GP practices and 23 community partners across Scotland and Northern Ireland. SPRING Social Prescribing support and make a difference to individuals, primary care networks, and the community, by co-creating health plans and supporting individuals throughout their health journey.  

We want to make sure that all link workers can spend as much time as possible with the individual to co-produce their social prescription as well as be able to adapt accordingly as their needs change. Equally, we want to make it as easy as possible for primary care professionals to make referrals as well as have full access to track anyone’s social prescribing journey.

Here our two-way integration with leading clinical software vision, SystmOne and EMIS Web aligns patient information and data across two systems to save time for the referrer, streamline the process, and help the individual seek the support they need quicker. This integration allows referrers to make a referral straight through to the Link Worker in a matter of clicks within their clinical system.

Merton Connected has benefitted massively since using Access Elemental and in turn have seen a massive increase in referrals. In the last year alone they have received over 2,000 referrals which have been effectively managed in our software at every point of an individual's social prescribing journey.   ​

It is clear therefore that social prescribing is a great strategy to overcome the wider social determinants of health. Here this non-clinical and holistic approach allows individuals to be more proactive in managing their health and wellbeing and understand the social factors that can impact their mental health and wellbeing.

Social prescribing is a great way to overcome these issues as it helps individuals identify the root causes of their ill-health. Through this process, individuals can not only see their mental health and wellbeing improve, but they can also learn skills they can continuously use and coping strategies to help them in the future.  Workload and pressure on clinicians can also reduce declining dependency on both primary and secondary care.

Summarising the benefits of social prescribing social determinants of health

This article has addressed how due to unprecedented events in the past few years, more and more people are struggling with different social determinants of health unexpectantly.  

Whether it is a housing, finance, or employment issue most of us will experience a negative impact of a social determinant of health in our lifetime, but some, mainly in more socially deprived areas, will suffer more than others.  

By the government upscaling the number of social prescribing projects across the country the pressure building on the NHS can be relieved.  Link Workers can offer alternative non-clinical treatments to help support individuals identify what’s affecting their health and wellbeing and provide practical, social, and emotional support.  

One of the ways you can ensure that no one is left with any unmet needs is through implementing a population health management approach. Here you can target specific groups so no cohort is left without the support they need.

Our digital social prescribing platform therefore offers Link Workers and social prescribing projects more efficient ways to connect individuals to non-clinical programmes and services in their local area and give you the capability to design, implement, measure, and report on the effectiveness of your social prescribing projects.

Discover our social prescribing platform today and contact us to find out more information on how our platform can help overcome the different social determinants of health in your local area today.