🎙️ Podcast Title: Secrets of Survival (S.O.S.) 🎧 Episode Title: The Blueprint of Wellbeing: Public Health and the Social Determinants of Health – Part I 🩺 Written and Narrated by: Dr. Susan Rashid 📍 Runtime: Approx. 31 minutes 🎓 Tone: Scholarly | Informed | Direct | Authoritative Episode Summary: What determines health—genes or geography, biology or infrastructure? In this powerful and data-driven opening to The Blueprint of Wellbeing, Dr. Susan Rashid unpacks the foundational framework of public health and the social determinants of health (SDOH)—those upstream, non-medical forces that shape how long and how well we live. Drawing from decades of public health research and field data, this episode moves beyond clinical models to examine how income, housing, education, transportation, and community conditions create measurable health outcomes. From under-resourced neighborhoods in New York City to isolated rural counties in Appalachia and long-neglected Indigenous communities across the United States, Dr. Rashid explores the systemic roots of health disparities with clarity, compassion, and scholarly precision. Listeners will gain an in-depth understanding of the five key domains of the SDOH, learn how inequity is patterned across geography and generations, and be invited to rethink what medicine can truly achieve when it moves beyond the exam room. This is Part I of a two-part series. Part II will focus on the clinical implications of SDOH—highlighting validated screening tools, best practices in patient-centered care, and what must change in healthcare systems and medical education to close the gap between knowledge and action. Topics Covered: The definition and purpose of public health The five domains of the social determinants of health Case studies: Urban inequality in NYC, rural isolation in Appalachia, structural neglect in Indigenous communities Intergenerational impact of systemic disparities The importance of reframing health through a structural and environmental lens Quotable Insight: "Where you live tells us more about how long you’ll live than any genetic test ever could." — Dr. Susan Rashid Listen now to begin reshaping how we define, teach, and deliver health in the 21st century.
🎙️ Podcast Title: Secrets of Survival (S.O.S.)
🎧 Episode Title: The Blueprint of Wellbeing: Public Health and the Social Determinants of Health – Part I
đź©ş Written and Narrated by: Dr. Susan Rashid
đź“Ť Runtime: Approx. 45 minutes
🎓 Tone: Scholarly | Informed | Direct | Authoritative
Episode Summary:
What determines health—genes or geography, biology or infrastructure?
In this powerful and data-driven opening to The Blueprint of Wellbeing, Dr. Susan Rashid unpacks the foundational framework of public health and the social determinants of health (SDOH)—those upstream, non-medical forces that shape how long and how well we live.
Drawing from decades of public health research and field data, this episode moves beyond clinical models to examine how income, housing, education, transportation, and community conditions create measurable health outcomes. From under-resourced neighborhoods in New York City to isolated rural counties in Appalachia and long-neglected Indigenous communities across the United States, Dr. Rashid explores the systemic roots of health disparities with clarity, compassion, and scholarly precision.
Listeners will gain an in-depth understanding of the five key domains of the SDOH, learn how inequity is patterned across geography and generations, and be invited to rethink what medicine can truly achieve when it moves beyond the exam room.
This is Part I of a two-part series. Part II will focus on the clinical implications of SDOH—highlighting validated screening tools, best practices in patient-centered care, and what must change in healthcare systems and medical education to close the gap between knowledge and action.
Topics Covered:
The definition and purpose of public health
The five domains of the social determinants of health
Case studies: Urban inequality in NYC, rural isolation in Appalachia, structural neglect in Indigenous communities
Intergenerational impact of systemic disparities
The importance of reframing health through a structural and environmental lens
Quotable Insight:
"Where you live tells us more about how long you’ll live than any genetic test ever could." — Dr. Susan Rashid
Listen now to begin reshaping how we define, teach, and deliver health in the 21st century.
🎙️ Podcast Title: Secrets of Survival (S.O.S.)
🎧 Episode Title: “The Blueprint of Wellbeing: Public Health and the Social Determinants of Health”
 🩺 Written and Narrated by Dr. Susan Rashid
📍 Runtime: Approx. 40–45 minutes
🎓 Tone: Scholarly | Informed | Direct | Authoritative
🎙️ Narrator Introduction:
Welcome to Secrets of Survival, a podcast exploring the systems, structures, and social conditions that shape health outcomes across the United States.
In today’s episode—“The Blueprint of Wellbeing: Public Health and the Social Determinants of Health”—we examine the upstream factors that influence health long before clinical care begins. From housing and education to transportation and safety, we explore the evidence behind how environments shape disease and longevity.
Guiding today’s episode is Dr. Susan Rashid—a physician, public health scholar, and founder of Rashid Media Productions. Dr. Rashid brings a clinically grounded, policy-informed perspective to the evolving intersection of medicine, equity, and public health.
Now, let’s begin.
[Opening ambient sound: A soft wind brushes over a quiet cityscape. In the distance, a commuter train hums along its track. The low rhythm of morning traffic pulses, underscoring the life of a waking metropolis.]
Introduction:Â
Dr. Susan Rashid (measured, precise, and composed):
What do we mean when we speak of “health”?
Is it simply the body’s silence in the face of disease?
Can it be captured in a chart—summarized by lab values, imaging results, or a physical exam?
Or is health something deeper?
An unfolding shaped by where one is born, how one is raised, the air one breathes, the choices one can actually make?
Long before a person steps into a clinic or meets a physician, their health has already been shaped—by policies, by environments, and by history.
These upstream forces are known as the Social Determinants of Health—a framework now central to 21st-century medicine and public health. They refer to the conditions into which people are born, in which they grow, work, live, and age—as well as the systems and structures that govern how illness is prevented, treated, and managed. From income and education to housing, transportation, access to nutritious food, and the structure of our healthcare systems—these determinants silently but powerfully construct the architecture of health outcomes across populations.
The evidence is clear. Where you live often tells us more about how long you’ll live than any genetic test ever could. Higher levels of education are consistently associated with lower rates of chronic disease, improved mental health, and greater access to preventive care. And when policies around housing, employment, and infrastructure are unequal, they produce health outcomes that are not coincidental—they are systemic, predictable, and measurable.
Yet despite decades of rigorous research and public health advocacy, the integration of social determinants into routine medical practice remains inconsistent. Clinical systems continue to address immediate symptoms while overlooking the systemic factors that drive them.
The result is a model of care that is fragmented—too often reactive rather than preventive.
Today, on Secrets of Survival (SOS), we step back from the exam room to examine the broader field of public health—its tools, its principles, and its responsibility to address these root causes of disease.
This episode—“The Blueprint of Wellbeing: Public Health and the Social Determinants of Health”—calls for a reframing of how we define and approach health itself.
Health is no longer a question of biology alone. It is a reflection of access, infrastructure, and public systems. And if we are to respond to disease effectively, we must begin by understanding the conditions that make it inevitable for some—and preventable for others.
Let us begin.
🎙 Segment I: Defining the Framework
Before we examine the social determinants of health, we must first establish a shared understanding of the broader field in which these determinants are studied, addressed, and reformed: public health.
Unlike clinical medicine, which focuses on diagnosing and treating illness in individuals, public health is concerned with the health of populations. It is a discipline rooted in prevention, longevity, and equity—aimed at improving health outcomes through coordinated systems, evidence-informed policy, and population-wide strategies.
At its core, public health seeks to build environments in which all people—regardless of income, geography, or background—have equitable access to the conditions that support health. These conditions include clean air and water, safe housing, access to nutritious food, quality education, economic opportunity, and a responsive healthcare system (Centers for Disease Control and Prevention, 2024).
Public health professionals do not treat illness in isolation; they examine the structural drivers of health—economic inequality, educational opportunity, housing stability, transportation access, environmental exposures, and labor conditions. These are not background variables. They are the primary forces that shape patterns of illness and wellness across populations. While clinical care often begins with the patient, public health begins with the question:
“What upstream factors created this pattern of illness in the first place?”
To understand those upstream factors, we turn to a globally recognized framework known as the Social Determinants of Health (SDOH).Â
According to the World Health Organization, “the social determinants of health are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (World Health Organization, 2023). These forces include public policy, economic practices, laws, and institutional infrastructure—domains that extend far beyond the exam room but define what care can achieve once a patient enters it.
Put simply: a person’s health is not determined solely by their biology or behavior. It is shaped by the world around them—by the opportunities they’ve had, the environments they’ve lived in, and the systems they’ve had to navigate or endure. These are not background details. They are the story.
To put this understanding into practice, public health scholars have identified five core domains that collectively define the social determinants of health:
This domain addresses whether individuals and families have consistent access to income, employment, food, and shelter. Job security, wage level, housing costs, and personal debt all influence the ability to afford care, medications, and safe living conditions. Financial instability contributes to chronic stress, nutritional deficits, and limited engagement with preventive services (Braveman et al., 2011).
Educational opportunity is a powerful predictor of health outcomes. This domain includes access to early childhood education, school quality, graduation rates, and higher education attainment. Those with less education are more likely to face barriers to employment, suffer from poor health literacy, and experience increased risk of chronic disease (Freudenberg & Ruglis, 2007).
While healthcare is only one component of overall health, its accessibility remains vital. This domain evaluates insurance coverage, provider availability, cultural and linguistic responsiveness, and quality of care. Inadequate access leads to delays in diagnosis, unmanaged illness, and higher mortality rates—especially in marginalized populations (Agency for Healthcare Research and Quality, 2023).
This domain examines the physical conditions of the places where people live. It includes housing safety, environmental exposure to pollutants, access to healthy food, public transportation, and green spaces. Communities that are physically degraded or environmentally hazardous face higher rates of asthma, injury, and exposure-related illness (Evans & Kantrowitz, 2002).
This domain includes the quality of relationships, exposure to violence or discrimination, civic participation, incarceration rates, and levels of social trust. Communities marked by racism, systemic injustice, and social fragmentation face elevated risks of hypertension, mental illness, and adverse maternal outcomes (Williams & Mohammed, 2009).
These five domains do not exist in isolation. They interact—often reinforcing one another across time and generations. A child born into a neighborhood with substandard housing may also attend underfunded schools, live near environmental hazards, and experience food insecurity. These interconnected disadvantages are not coincidental. They are the result of structural decisions and sustained institutional patterns.
Understanding health through this lens requires us to shift our focus—from treating downstream symptoms to addressing upstream conditions. Public health gives us the language, tools, and strategies to make that shift.
And if we are serious about improving health outcomes, reducing disparities, and advancing equity, then public health must move from the margins of the healthcare conversation to its very center.
References (MLA format):
🧬*Segment II: From Data to Disparity
Narrated by Dr. Susan Rashid
To understand the impact of social determinants on health outcomes, we must move beyond theory and confront the data—and the disparities they reveal.
What is fascinating is that medical care influences only a small fraction of our health. In fact, research shows that just 10 to 20 percent of modifiable health outcomes are shaped by clinical interventions. The remaining 80 to 90 percent stem from what we now call the social determinants of health—our behaviors, our socioeconomic realities, and the environments we inhabit each day. (Hood et al., 2016; Magnan, 2017).
These numbers are not abstract. They translate into decades of life lost, preventable disease, and chronic inequity.
Let us consider just a few examples:
🎙️ Urban Health Inequity in New York City
In New York City, life expectancy can vary by more than a decade between neighborhoods. Children born in Brownsville, Brooklyn, one of the City's lowest‑income communities, can expect to live around 75 years. Meanwhile, in Manhattan’s Upper East Side, the average life expectancy is close to 86 years—a striking 11-year difference (Roadmap For Health Equity In New York City et al., 2022). This disparity is not a matter of genetics or clinical care; it reflects profound differences in income, housing, education, environmental hazards, and investment in the built environment.
🎙️ Geographic Isolation in Rural Appalachia
“In many areas of rural Appalachia, residents face significant structural barriers to care—not only due to a lack of public transportation but also insufficient broadband infrastructure. Between 2018 and 2022, approximately 73 rural Appalachian counties had less than 75 percent household broadband access—lagging nearly 4 percent behind the national average (Appalachian Regional Commission). This digital divide directly limits access to telemedicine, preventive screenings, and specialist care, reinforcing longstanding geographic isolation.
Additionally, a 2023 investigation in rural Kentucky found that counties with poor connectivity among insurers and social services had notably higher rates of potentially preventable hospitalizations, particularly for chronic conditions like diabetes (Hogg-Graham et al. 2023). These findings demonstrate that physical and digital access barriers in rural Appalachia have real health consequences—from unmanaged diabetes to elevated opioid-related mortality.
🎙️ Structural Health Inequity in Indigenous Communities
Indigenous populations across the United States continue to experience the enduring health consequences of forced displacement, cultural erasure, and chronic underfunding of their healthcare systems. Their rates of chronic illness—like diabetes, depression, and substance use disorder—along with tragically high suicide rates, are all linked to historical trauma and policy neglect.
Recent data underscore these ongoing disparities:
These disparities are not anomalies.
They are patterned outcomes—repeated across regions, populations, and generations.
They are the result of public policy, resource allocation, environmental regulation, incarceration trends, educational investment, and the cumulative effects of long-standing social disadvantage.
In public health, these outcomes are understood as the predictable result of social conditions, institutional practices, and long-term structural patterns.
When we see life expectancy varying by neighborhood, preventable diseases escalating in specific regions, or mental health crises affecting entire communities—we are not observing isolated events.
We are witnessing systemic symptoms of deeply embedded conditions.
🎙️ Segment Conclusion – Part I
As we’ve seen, health disparities are not random—they are structured, patterned, and deeply embedded in the social and environmental fabric of our communities. From low-income neighborhoods in New York City, to remote counties in rural Appalachia, to Native American and Indigenous lands long affected by systemic neglect—the evidence is clear: place, policy, and social conditions shape health in measurable and enduring ways.
But knowing the data is only the beginning.
This concludes Part I of The Blueprint of Wellbeing, where we explored the foundational framework of public health and the broad societal forces known as the social determinants of health.
In Part II, we turn to the clinical setting—where these upstream factors often enter the room unspoken. We’ll examine how health-related social needs are screened, how clinicians can respond with precision and empathy, and what must evolve in medical education and healthcare delivery to close the gap between knowledge and action.
Before we part, I offer my deepest and most reverent gratitude:
To my beloved family—Your love is the foundation of every truth I speak.Â
To my loyal friends and unwavering colleagues—Thank you for standing beside me with honor, integrity, and unwavering belief in the importance of telling stories and content that matter.Â
To my gifted audio and sound engineers—You turn breath into atmosphere. Word into world. Thank you for shaping this podcast into more than sound—for turning it into a sacred space where knowledge and compassion meet.
To my security team - Thank you for guarding the threshold of this mission.Â
To my secretaries and coordinators—You are the quiet brilliance behind the rhythm of this production.
To my legal team—Thank you for ensuring that every word I speak, every script I write, and every insight I share is protected with the full weight of watermark, authorship, and law.Â
And most of all, to you—
Our global audience of listeners, learners, clinicians, scholars, and seekers.
Thank you for believing that health is more than diagnosis, that healing requires story, and that medicine must meet the world as it truly is.
Until our next chapter in Secrets of Survival (SOS),
May you breathe with awareness,
May you practice with courage,
And may you carry this blueprint of wellbeing into every corner of the world you touch.
With all my gratitude,
I’m Dr. Susan Rashid.
Thank you for joining me.Â
References (MLA Format):