Social Determinants of Health Embracing Healthy Work in Boone County Precarious employment is a complex issue that has a profound impact on an increasing number of workers in all economic sectors, resulting in adverse worker, family, and community health outcomes. The U.S., despite spending far more on medical care than any other country in the world, has poorer health outcomes than most other de … Social Determinants of Health: How Social and Economic Factors Affect Health 3 While the previous scenario is fictional, unfortunately it is all too plausible. Introduction. Correlated with income and race, education directly impacts employment. This in turn influences a household’s ability to cover health related expenses and utilize tools, such as health insurance for preventative care, which can be used to pay for annual examinations and vaccinations. The County Health Rankings (CHR) provides data for nearly every county in the U.S. on four modifiable groups of health factors, including healthy behaviors, clinical care, physical environment, and socioeconomic conditions, and on health outcomes such as length and quality of life. The trends explored in this year's County Health Rankings Key Findings Report included levels of social and economic disparity, residential segregation, children living in poverty, and teen births. 89% of health occurs outside of the clinical space through our genetics, behavior, environment and social circumstances. This indicator shows the ranking of the county in social and economic factors according to the County Health Rankings. The social determinants of health also determine access and quality of medical care—sometimes referred to as medical social determinants of health (see Figure 1 for the County Health Rankings model of factors shaping health). Determinants of Health Health is more than medical care. While the U.S. is an outlier for health spending, its spending looks more similar to that of other countries when health spending is combined with spending on other social services (such as cash assistance and other support for the elderly, poor, unemployed, and other disadvantaged or vulnerable populations). *Source: County Health Rankings, 2016. Education.