Understanding Disparities:
Social Determinants of Health (SDOH) & Vaccination

Health care professionals like you play a critical role in
achieving vaccine equity.1

When it comes to certain vaccination rates, some communities continue to lag behind.2,3,4

According to data provided by the US Department of Health and Human Services, in recent years:

  • ~30% of Hispanic adults have been less likely to have received certain recommended vaccines, compared to non-Hispanic Whites.2
  • For children up to 24 months born during 2018-2019, coverage with most childhood vaccines was lower among those who were uninsured, Black, Hispanic, or living below the federal poverty level5,a

Now more than ever, it’s critical to examine and address underlying SDOH that create challenges to vaccination access and acceptance.6

aChildren’s race/ethnicity was reported by the parent or guardian. Children identified in this report as White, Black, Asian, AI/AN, NHPI, or multiple races were reported by the parent or guardian as non-Hispanic. Children identified as being of multiple races had more than one race category selected. Children identified as Hispanic might be of any race.7

The non-medical factors that influence health outcomes

SDOH are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the circumstances of daily life.8

Acting at the individual, community, and systemic levels, SDOH can contribute to a wide range of health inequities and disparities for your patients.9,10

Examples of SDOH10:

  • Access to nutritious foods and physical activity opportunities
  • Education, job opportunities, and income
  • Language and literacy skills
  • Polluted air and water
  • Racism, discrimination, and violence
  • Safe housing, transportation, and neighborhoods
Non-Medical Social Determinants of Health

SDOH domains10

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Learn More About SDOH

You can make
a difference

Outside of clinical care, SDOH are estimated to account for up to 80% of the modifiable contributors to healthy outcomes for a population.8,11,b

Learn more about the impact of SDOH and how this information can help you address vaccination gaps in your practice:

  • Take time to identify and understand examples of disparities in both the pediatric and adult populations within your state.
  • Learn about tailored interventions that address barriers to vaccination.
  • Discover techniques you can employ to support vaccine equity.
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More ways to help

bThe County Health Rankings (CHR) model developed by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, delineates the underlying modifiable determinants of health and groups them into four main categories (with associated weights): healthy behaviors (30%), physical environment (10%), social and economic factors (40%) and clinical care (20%).11

ref1

Reference

  1. Centers for Disease Control and Prevention (CDC). Talking with parents about vaccines for infants. Reviewed April 11, 2018. Accessed May 8, 2023. https://www.cdc.gov/vaccines/hcp/conversations/talking-with-parents.html
ref2

Reference

  1. US Department of Health and Human Services Office of Minority Health. Immunizations and Hispanic Americans. Last modified December 14, 2020. Accessed February 22, 2023. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=67
ref3

Reference

  1. US Department of Health and Human Services Office of Minority Health. Immunizations and African Americans. Last modified February 17, 2023. Accessed July 7, 2023. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=22
ref4

Reference

  1. US Department of Health and Human Services Office of Minority Health. Immunizations and Asian Americans. Last modified December 14, 2020. Accessed February 22, 2023. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=52
ref5

Reference

  1. Hill HA, Chen M, Elam-Evans LD, Yankey D, Singleton JA. Vaccination Coverage by age 24 months among children born during 2018-2019 – National Immunization Survey-Child, United States, 2019-2021. MMWR Morb Mortal Wkly Rep. 2023;72(2):33-38. doi:10.15585/mmwr.mm7202a3
ref6

Reference

  1. Sangster AV, Barratt JM. Towards ending immunization inequity. Vaccines (Basel). 2021;9(12):1378. doi:10.3390/vaccines9121378
ref7

Reference

  1. Hill HA, Chen M, Elam-Evans LD, Yankey D, Singleton JA. Vaccination coverage by age 24 months among children born in 2018 and 2019 – national immunization survey-child, United States, 2019-2021. Supplemental Tables 1-3. MMWR Morb Mortal Wkly Rep. 2023;72(2):33-38. doi:10.15585/mmwr.mm7202a3
ref8

Reference

  1. Social determinants of health at CDC. Centers for Disease Control and Prevention. Last reviewed December 8, 2022. Accessed February 26, 2023. https://www.cdc.gov/about/sdoh/index.html
ref9

Reference

  1. Societal factors that influence health. American Hospital Association. Accessed March 30, 2023. aha.org/societalfactors
ref10

Reference

  1. Social determinants of health. Healthy People 2030. Accessed April 25, 2023. https://health.gov/healthypeople/priority-areas/social-determinants-health
ref11

Reference

  1. Hood, CM, Gennuso KP, Swain GR, Catlin BB. County health rankings: relationships between determinant factors and health outcomes. Am J Prev Med. 2016;50(2):129-135. Epub 2015 Oct 31. doi:10.1016/j.amepre.2015.08.024
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