Social and Cultural Factors in Health

Social scientists have made significant strides in shedding light on the basic social and cultural structures and processes that influence health. Social and cultural factors influence health by affecting exposure and vulnerability to disease, risk-taking behaviors, the effectiveness of health promotion efforts, and access to, availability of, and quality of health care. Social and cultural factors also play a role in shaping perceptions of and responses to health problems and the impact of poor health on individuals' lives and well-being. In addition, such factors contribute to understanding societal and population processes such as current and changing rates of morbidity, survival, and mortality. Numerous reports from the Institute of Medicine and National Research Council have pointed to the importance of social and cultural factors for health and the opportunities for improving health through a better understanding of mechanisms linking the social and cultural environment to specific health outcomes. To realize these opportunities, social science research related to health must be further developed and ultimately integrated into interdisciplinary, multi-level studies of health. Linking research from the macro-societal levels, through behavioral and psychological levels, to the biology of disease will provide the integrative health research necessary to fully understand health and illness.

African American, Native Americans, and low socioeconomic status (SES) populations continue to experience substantial disparities in the burden of disease and death when compared to the European-Americans and higher SES populations. Because the existence of racial/ethnic, social class, and rural-urban health disparities are to a large extent influenced by behavioral and social factors, the Office of Behavioral and Social Sciences Research is committed to developing better knowledge of their specific causes and participating in finding solutions.

Low health literacy is a wide spread problem, affecting more than 90 million adults in the United States, where 43% of adults demonstrate only the most basic or below-basic levels of prose literacy. Low health literacy results in patients’ inadequate engagement in decisions regarding their health care and can hinder their ability to realize the benefits of health care advances. Research has linked low or limited health literacy with such adverse outcomes as poorer self-management of chronic diseases, fewer healthy behaviors, higher rates of hospitalizations, and overall poorer health outcomes.