physical & mental health and access to care

Why this is important: Physical and mental health are influenced by not only disease processes and lifestyle behaviors, but also social determinants of health (SDOH), defined as “the conditions in which people are born, grow, live, work, and age.”1 For example, income, employment, access to quality education and healthcare, and larger-scale circumstances like the built environment (e.g., air pollution, availability of open spaces and public transportation) impact people’s health and well-being. 

Although many measures of population health focus on death rates and disease processes—things that can be directly observed—people’s social well-being and how they feel about their own health is also important for capturing a more complete picture of health. Regardless of how physically ill or healthy someone is, how they feel about their general health, also called “self-rated health,” is a consistently strong predictor of outcomes like how long someone will live.2 

Collecting data on the perceived health and well-being of community members and barriers to accessing health care services helps public health organizations and community partners (e.g., healthcare systems, government agencies and non-profit organizations) to identify disparities and to develop strategies for improving residents’ health and well-being.

Definition: Health is not simply the absence of disease, but state of complete physical, mental and social well-being.3

The Quality of Life (QoL) Survey assessed residents’ health in a few ways. Three questions asked respondents to rate their general physical health, oral/dental health and mental/emotional health, respectively. Response options were “Poor,” “Fair,” “Good,” “Very good” and “Excellent.” The survey also included questions about respondents’ number of days during the last month with poor mental health, and their levels of stress in the last 12 months related to the following experiences: health concerns for oneself or a family member; difficulties in accessing health care for oneself or for family; limited ability to work or care for children due to a serious illness in the household; concerns about aging parent(s); becoming a caregiver for another child or older adult; and other major life stressors (e.g., work and finances).

The QoL Survey also assessed access to health services with a question about respondents’ barriers to seeing a medical and dental provider (e.g., health insurance, costs, scheduling and transportation). In 2020, this question was modified to add response options related to the role of COVID-19 as a barrier to seeing both types of providers. Respondents were also asked if they received treatment or counseling for any mental health issue in the last 12 months, and if applicable, reasons why they did not receive treatment or counseling (e.g., affordability, stigma and negative expectations). 

Data Source: 1 Centers for Disease Control and Prevention. Social Determinants of Health: Know What Affects Health. 2018. Retrieved from Last updated March 10, 2021. Accessed December 30, 2021. 2 Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behavior. 1997:21-37. 3 Constitution of the World Health Organization. In: World Health Organization. Handbook of basic documents. 5th ed. Geneva: Palais des Nations, 1952:3-20.