The relevance of social and structural factors (see Appendix 1) to health, quality of life, and life expectancy has been amply documented and extends to mental health. Pertinent variables include the following (Compton & Shim, 2015):
- Discrimination, racism, and social exclusion
- Adverse early life experiences
- Poor education
- Unemployment, underemployment, and job insecurity
- Income inequality
- Poverty
- Neighborhood deprivation
- Food insecurity
- Poor housing quality and housing instability
- Poor access to mental health care
All of these variables impede access to care, which is critical to individual health, and the attainment of social equity. These are essential to the pursuit of happiness, described in this country’s founding document as an “inalienable right.” It is from this that our profession derives its duty to address the social determinants of health.