Social Determinants of Health for Fitness Professionals

Fitness and health are about so much more than effort, motivation, the grind, or not giving up. As fitness professionals we see people for the most part who are already in the gym, but unless we understand what it took them to get there, providing effective and compassionate help and advice won’t be possible. The factors that play into a person’s ability to be healthy are called thee social determinants of health, and understanding of these is imperative as health and fitness practitioners. 

Social determinants are defined as the conditions in the places where people live, learn, work, and play and how they affect a wide range of health risks and outcomes.1 These conditions are known as social determinants of health (SDOH).1

Examples of social determinants include:

  • Availability of resources to meet daily needs (e.g., safe housing and local food markets)
  • Access to educational, economic, and job opportunities
  • Access to health care services
  • Quality of education and job training
  • Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
  • Transportation options
  • Public safety
  • Social support
  • Social norms and attitudes (e.g., discrimination, racism, and distrust of government)
  • Exposure to crime, violence, and social disorder (e.g., presence of trash and lack of cooperation in a community)
  • Socioeconomic conditions (e.g., concentrated poverty and the stressful conditions that accompany it)
  • Residential segregation
  • Language/Literacy
  • Access to mass media and emerging technologies (e.g., cell phones, the Internet, and social media)
  • Culture

We know that poverty limits access to healthy foods, safe neighborhoods for walking, and that more education is a predictor of better health. However, even when you control for factors like educational level, the wealth disparities are apparent between races (see figure below). Having money to invest in health and fitness is arguably the biggest barrier. Gyms cost money, working out takes time which is money in our capitalist society, equipment costs money. As someone practicing in the field I can tell you anecdotally that when people invest financially in their fitness goals, they are much more likely to succeed. However, the conversations about poverty and race cannot be untangled.

Barr, Donald A. Health Disparities in the United States: Social Class, Race, Ethnicity, and Health. Johns Hopkins University Press, 2014.

The pre workout that is $1-2 per serving that I swear by, the perfectly fitting lulu pants or Brooks running shoes, the fact that I have free access to a full functional training center (all things that I love by the way) are things that are not accessible to many people. My privilege in fitness has nothing to do with the fact that I haven’t worked hard, because I have. But I have also had many advantages, and *fewer obstacles* to overcome. In the sphere of fitness influencing we often talk about motivation and discipline as the biggest barriers to success. However, that is a very limited point of view when considering the social determinants of health and can be a really toxic message, although well intentioned. 

We need to acknowledge that many of us as fitness influencers are speaking to a population that is SIMILAR TO US! We are speaking to a privileged population. But tell me, how would you assist a client without the same resources as you. I know on Instagram we cater to our “ideal client” or “ideal audience” and often times those are people who look, live, even exercise like us. But that leaves low income folks, black folks, older folks, disabled folks, entirely out of the conversation. The idea that if we all just worked hard enough and were disciplined enough that we could have the body we want is a very exclusive point of view, and one that I’ve been guilty of perpetuating as well. I have a unique position being both in the Instagram realm of fitness, and on the ground in a Y, and let me tell you there are two very different kinds of clients. 

So I challenge us all to think about our messages, logos, brands, partnerships, and figure out ways to make them more inclusive. To listen FIRST and listen MORE before we advise.

Sources:

“Social Determinants of Health.” Social Determinants of Health | Healthy People 2020, http://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health.

Barr, Donald A. Health Disparities in the United States: Social Class, Race, Ethnicity, and Health. Johns Hopkins University Press, 2014.

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