In the age of pandemics, climate change, and rising global inequalities, health is no longer a question of biology alone. The One Health framework—a collaborative, multisectoral, and transdisciplinary approach—recognizes that the health of humans, animals, and the environment are inextricably linked. Yet, while it is easy to focus on pathogens, vectors, and species jumps, a crucial layer is often overlooked: the social determinants of health (SDH).
Social determinants are the non-medical factors that influence health outcomes. These include conditions in which people are born, grow, live, work, and age, shaped by forces such as economics, politics, and culture. Integrating this social lens into the One Health approach is essential for building truly equitable and effective health systems.
Why Social Determinants Matter in One Health
When zoonotic diseases like Ebola or COVID-19 make headlines, discussions often center on viruses and wildlife. But the reasons these diseases spread and hit certain communities harder are deeply rooted in social structures. Poverty, lack of access to clean water, crowded housing, limited healthcare access, informal labor conditions, and weak governance all shape vulnerability and resilience to disease.
Take, for example, deforestation driven by agricultural expansion. This environmental change not only displaces wildlife and increases human-animal contact, but it often disproportionately affects Indigenous communities who rely on forests for their livelihoods. The resulting health impacts are compounded by historical marginalization, poor infrastructure, and underinvestment in rural health services.
A One Health framework that ignores these social conditions is incomplete.
Key Social Determinants Within the One Health Context
1. Economic Inequality and Livelihoods
In many rural or peri-urban settings, livestock keeping, farming, and informal markets are critical for survival. People in these contexts often live in close proximity to animals, increasing the risk of zoonotic spillovers. However, the problem isn’t proximity alone—it’s the lack of choice. Poorer households are less able to access veterinary care, implement biosecurity measures, or relocate from high-risk areas. One Health interventions must therefore address livelihood security and economic inclusion.
2. Education and Awareness
Health literacy plays a powerful role in how communities perceive and respond to disease threats. Misunderstandings about vaccination, antimicrobial resistance, or wildlife risks can hinder public health efforts. Culturally sensitive education campaigns, designed with community input, are vital to changing behaviors and building trust.
3. Infrastructure and Access to Services
Basic infrastructure—clean water, waste disposal, transportation, and healthcare facilities—is a cornerstone of health. In many low-income regions, the absence of these services fuels cycles of illness. An effective One Health approach must advocate for investments that cut across sectors: clinics, schools, veterinary stations, and roads.
4. Gender and Social Roles
Women and children often bear the burden of caregiving, water collection, food preparation, and animal tending. These roles expose them to different health risks, such as brucellosis from livestock or infections from poor sanitation. Gender-sensitive planning can ensure interventions do not exacerbate existing inequalities and instead empower those most at risk.
5. Political Will and Governance
The ability to implement One Health initiatives depends heavily on political commitment and intersectoral coordination. Yet, communities in conflict zones, unrecognized settlements, or under authoritarian rule may lack access to basic rights and protections. A rights-based approach is critical to ensure that One Health efforts are inclusive and just.
From Top-Down to Bottom-Up: Community-Centered Solutions
A truly integrative One Health strategy does not impose solutions from the top but builds them from the ground up. Communities are not just recipients of aid or information—they are knowledge holders and essential partners. Local farmers, traditional healers, and Indigenous leaders often have deep ecological knowledge that can enhance disease surveillance, early warning systems, and sustainable resource management.
Participatory research, community co-design of interventions, and the incorporation of traditional ecological knowledge are powerful tools to align One Health with social justice.
A Call to Action
Health is not created in hospitals or laboratories alone. It is shaped in kitchens, schools, farms, forests, and political halls. If One Health is to fulfill its promise of preventing pandemics and promoting well-being across species and ecosystems, it must embrace the social determinants of health.
This means moving beyond reactive, disease-center means moving beyond reactive, disease-centered interventions toward holistic, anticipatory approaches that recognize inequality, marginalization, and injustice as core drivers of vulnerability. It requires interdisciplinary collaboration not only among doctors, veterinarians, and ecologists, but also with anthropologists, sociologists, economists, and—most importantly—communities themselves.
Only by addressing the root causes of health disparities can we hope to build a resilient, equitable, and sustainable world.
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