Social Determinants of Health Assessment

Helps professionals assess an individual’s social determinants of health based on lifestyle and personal aspects as well as family history of diseases.


1 Are you worried or concerned that in the next two months you may not have stable housing that you own, rent, or stay in as a part of a household?
2 Think about the place you live. Do you have problems with any of the following?


3 Within the past 12 months, you worried that your food would run out before you got money to buy more.
4 Within the past 12 months, the food you bought just did not last and you did not have money to get more.


5 Do you put off or neglect going to the doctor because of distance or transportation?


6 In the past 12 months has the electric, gas, oil, or Water Company threatened to shut off services in your home?

Child Care:

7 Do problems getting childcare make it difficult for you to work or study?


8 Do you have a job?


9 Do you have a high school degree?


10 How often does this describe you? I do not have enough money to pay my bills:

Personal Safety:

11 How often does anyone, including family, physically hurt you?
12 How often does anyone, including family, insult or talk down To you?
13 How often does anyone, including family, threaten you with harm?
14 How often does anyone, including family, scream or curse at you?

Family History:

15 Do you have a history of the following in your family?

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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.

According to the World Health Organisation, SDHs are defined as non-medical factors that can influence health outcomes. They contribute to wide health disparities and inequities range from the conditions in which people are born, grow, live and age to the wider influences that shape conditions of daily living.

SDHs may be categorised in the following domains:

  • Economic Stability
  • Education Access and Quality
  • Health Care Access and Quality
  • Neighbourhood and Built Environment
  • Social and Community Context

Social determinants were also found to be more important than health care or lifestyle choices in influencing health so addressing them appropriately in healthcare is fundamental for improving health and quality of life of patients.

The above SDH form aids in evaluating a range of social determinants from the following categories:

  • Quality of housing conditions;
  • Access to food;
  • Transport limitations preventing one from accessing health;
  • Access to basic utilities;
  • Childcare access limitations;
  • Education and employment status;
  • Financial status;
  • Personal safety;
  • Family history of health conditions.

Specialty: Miscellaneous

Abbreviation: SDH