Social Determinants of Physical Frailty

Social determinants of health encompass complex societal factors that can greatly impact individuals’ health and well-being across the lifespan. Among several proposed frameworks, the World Health Organization has conceptualized social determinants as interconnected factors that include: (1) structural determinants (health inequity, income/poverty, education); (2) social cohesion and social capital (social connections, social environment); (3) material circumstances (neighborhood and built environment: walkability, pollution, housing/transportation); and (4) health system (healthcare access and quality). In this chapter, we examine the social determinants that potentially influence the development and/or exacerbation of physical frailty in older adults. Physical frailty is conceptualized as a medical syndrome characterized by reduced physiological reserve and heightened vulnerability to stressors. Indicators of physical frailty include declines in physical function, muscle mass and strength, and endurance. We aim to summarize existing research on the social determinants of physical frailty and to highlight knowledge gaps. Understanding the impact of social determinants on physical frailty can contribute to the development of targeted interventions and policies aimed at promoting healthy aging and mitigating the adverse effects of frailty.