1 Ahmed Guessoum The Social Determinants of Health in Three Urban Communities The Social Determinants of Health , or SDOH , are basically the different conditions where people live, learn, work, and play. These conditions are influenced by things like how much money people have, their power in society, and whether they can get resources easily. All these factors together affect a person’s health and overall well - being. They also help explain why some groups tend to be healthier than others. One big factor is Health Care Access and Quality . This means how easy it is to find doctors, get primary care , and receive good quality of care . For instance, if someone needs to see a specialist like a neurologist or surgeon, they might have to wait weeks or even months just because there aren’t enough doctors ( provider availability ). Some communities also face poor quality of care where patients feel rushed during visits, while insurance gets charged for expensive treatments. These problems can cause de lays in diagnosing illnesses and make health worse over time. Another important part is the Social and Community Context , which is about the social environment and relationships around a person. Issues here include support systems , discrimination , and community participation . In many crowded immigrant neighborhoods, mental health is a taboo topic, and people might avoid things like voting or other civic activities. When people don’t participate in their community ( community participation ), important health problems often get ignored, and resources stay out of reach. 2 Economic Stability looks at whether people have a steady income to cover basic needs related to health. Problems like poverty , employment , disability , and food security all fall into this category. If someone struggles to keep a stable job ( employment ), it can create a domino effect — making it hard to pay for food, housing, and other necessities. This financial stress affects both physical and mental health, not just for the individual but for their whole family. Education Access and Quality means having the chance to get an education throughout life, from early childhood to college and beyond. Challenges here include literacy , language barriers , high school graduation rates , and access to higher education . In many immigrant communities, literacy is a major hurdle, especially for adults who come to the U.S. later in life. These people might be focused on supporting their families and don’t get the chance to study formally. This situation can cause emotional stress , insecurity, and fewer job options, all of which hurt their health and well - being. Lastly, the Neighborhood and Built Environment refers to where people live and how those places affect their health. Access to healthy food and the overall environment are key here. A food desert is a neighborhood where fresh, affordable, and nutritious food is hard to find. On the other hand, a food swamp is an area packed with fast food and processed, unhealthy options. Many low - income neighborhoods face both issues. They are often full of fast food places offering cheap but unhealthy meals high in fat, salt, and cholesterol. Because of this, people rely on unhealthy food for convenience, which leads to serious health problems like diabetes, high cholesterol, and heart disease. This paper mainly focuses on Access to Healthy Foods and Environmental Conditions in three urban communities.