Beyond healthcare: Addressing social determinants to achieve equitable and sustainable global health

Health outcomes are shaped not only by healthcare but also by the social, economic, and environmental conditions in which people are born, grow, live, work, and age. This narrative review examines how social determinants of health (SDH) such as income, education, housing, employment, gender, and environmental quality shape population health outcomes and contribute to persistent global health inequities. Evidence from peer-reviewed literature and global policy reports published between 2010 and 2024 was synthesized to identify key pathways through which social conditions influence health and to examine strategies for promoting health equity. The review highlights that clinical care accounts for only a small proportion of population health outcomes, whereas social and structural determinants drive the majority of health disparities. Multisectoral policy interventions addressing education, economic opportunity, housing, and environmental conditions are therefore essential for sustainable health improvement. Integrating SDH into national and global health agendas is critical for advancing the Sustainable Development Goals (SDGs), particularly those targeting poverty reduction, education, gender equality, and climate action. Achieving universal health equity ultimately requires transforming social structures and governance systems that perpetuate disadvantage, ensuring that all individuals regardless of socioeconomic status or geographic location have the opportunity to attain optimal health.