Newly released: Recommendations from the Robert Wood Johnson Foundation Commission to Build a Healthier America. Time to Act: Investing in the Health of Our Children and Communities calls for action on early childhood, healthy communities, and bridging health and health care. Read the report and explore the charts, infographics, and videos at

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What Drives Health

Good health.  It seems so straightforward. Eat right, exercise and get regular checkups. Yet achieving – and maintaining – good health is a battle that many Americans are losing every day. Some of the factors affecting our health we certainly can influence on our own; many of the factors, however, are outside our individual control. 

Where we live, work, learn and play dramatically affects the health of all Americans – for better or for worse. The sometimes toxic relationship between how we live our lives and the economic, social and physical environments that surround us has resulted in some of America's most persistent health problems.  At the same time, improving conditions in our homes, schools, workplaces and communities can help create greater opportunities for healthy lives. 

Social Factors

Social factors can affect health directly and indirectly as their effects accumulate across individuals' lifetimes and across generations, leading to vicious cycles between social factors and health. Although genes and medical care also are important, social factors probably play a greater role than either, and interact with both. Fortunately, many social factors can be influenced by policies and programs.

Social factors:

  • Early Life Experience

    Early childhood experiences can have powerful influences on an individual's health, not just in childhood but throughout life. Children born premature and underweight are more likely to face health problems than their peers, which can later lead to other factors which negatively impact health. Read more

  • Education

    Education has profound health effects. More education makes an individual more aware of healthy and unhealthy choices and makes it easier to make healthy choices. Read more

  • Income

    For centuries, poverty has been linked to ill health. It is not difficult to understand why the poor would have worse health than people with greater economic means. We now know that even middle-class people generally have poorer health than the most affluent. Read more

  • Work

    Work can influence health in many ways, including through links both with health care insurance and with physically hazardous exposures in the workplace. Read more

  • Housing

    Poor-quality housing poses a risk of exposure to many conditions that can contribute to poor health, such as indoor allergens that can lead to and exacerbate asthma, injuries, and exposure to lead and other toxic substances. Read more

  • Community

    Characteristics of communities can influence health in many direct and indirect ways. For example, neighborhoods can be physically hazardous because of air and chemical pollution, traffic, lack of sidewalks and safe places to exercise, and because of crime. Read more

  • Race and Ethnicity

    Racial and ethnic background has profound effects on an individual’s health primarily because of the different social and economic experiences – advantages and disadvantages – that go along with race and ethnicity. Read more

  • The Economy

    The general economic environment can affect health by affecting levels of unemployment, wages and benefits, barriers to educational attainment, and availability of social and health services. Read more