Research Paper Example: Determinants of Health

The health of an individual living in a certain region is determined by his/her emotional and physical probes which make him/her responsive to his/her surroundings. In our surrounding the people around us form our social world while the physical features and factors are part of our environmental world. A good social standing and environment are components of healthy living. This paper explores the environmental and social factors that determine the health index of the tri-state mid-Atlantic region in the United States. The region specifically constitutes Washington, Maryland, and Virginia states. The paper looks at most of the aspects of the environment that determine the suitability of residence and vulnerability of a person to unhealthy conditions. Some of the parameters considered include the cost of living, neighborhood, racial profiling, access to quality medical healthcare, lifestyle, the social capital, and chronic stress levels as social factors. The environmental factors include housing, radiation, access to clean water, pollution and the transport system.

Social and Environmental Determinants of Health Disparities in the Tri-State Mid -Atlantic Region and Policy Considerations for Policy Developments

The determinants of health are circumstances in which people live from their birth to old age and a health care system accessible to them (CDC, 2015). The determinants targeted in this case are those that directly affect the health living of people in a certain area. The circumstances of such nature are determined at a macro level rather than on a micro level. Some of the determinants include social, economic, environmental, and political factors present within an area. Each State in the United States provides a different living condition for its people. There are those cities in America, or around the world, where people are more prone to certain health conditions than other cities.

Disparities are obvious and unavoidable in any social system. Disparities in health are secondary; arising from disparities in social classes, and standards of living of different places across a specified place. The socio-economic differences of people in a certain region determine their level of vulnerability to diseases. For instance, people living in affluent backgrounds are more likely to stay healthy for longer periods compared to children living in less a slum. Some diseases are restricted to places where majorities of the people are of the lower social standing. A good example of a health disparity that comes as a result of the standard of living is the infant mortality rate.

Statistics from around the world

Women in Bolivia with at least high school education have lower rates of infant mortality, at 4% than women with no education whose rate stands at 10%. The life expectancy of Australian indigenous citizens is lower compared to that of non-indigenous people. To emphasize the essence of this study, statistics from England show that men in Glasgow (at 54 years) have 28 years shorter lives on average compared to their counterparts in Lenzie. The two towns are only a few kilometers apart. The average rate for disabilities for people above the age of eighty years is 58.8% for the lowly educated. The rate of disabilities for the highly educated people stands at 40.2% (WHO, 2015). Despite these disparities in community characteristics, health care is essential for communities. As such, it is the responsibility of the government to provide primary health care for all citizens regardless of their environmental or social disposition.

Social Factors of Health Disparities in the Tristate of Maryland, Washington D.C, Virginia


This area is referred to as the Washington Metropolis. Being the Capital of the United States of America, Washington is a city with a high standard of living, levels of education. As a result, people lead more affluent lives than other parts of the United States. People in this city are more motivated to succeed. They spend longer hours to work but allocate shorter time for socialization.

Washington is also the Political capital of the country. Any policies passed by the Congress affect this city first before their implementation in other areas of the country. For example, the Affordable healthcare act popularly known as the Obamacare is a nationwide policy but its implementation is stricter in Washington and its environments than in other states. As stated before, more educated people with stable incomes are more likely to lead healthy lives and produce healthier children. Most of the parents in Washington are health-conscious and tend to take health tips and advice more seriously. Children in this state go for checkup even for minor signs of illness.

The Socioeconomic position (SEP) of a region is a term that scientists use to describe a region’s social resources and materials accessible to people. It essentially stands for the social ranking of people. People of lower SEPs tend to die younger than their counterparts with higher SEPs. The past 100 years have seen tremendous changes in the United States health care system, seeing a major shift in the causes of health issues in Washington from infectious to chronic diseases. Cases of cancer, diabetes, and cardiovascular diseases have been on the rise in the past few years and continued to rise even further. The SEP level of the individual counts, but the average SEP of the community in which an individual lives is much more important. There is a complex relationship between the community’s SEP and an individual’s, but it is realistic. For instance, the effects on the health status of a person of the lower socio-economic standing could begin before birth and manifest itself years after birth after accumulation.

Socioeconomic Factors that Affect healthcare in Washington

Chronic stress: This condition results from a reaction to the emotional pressure that someone suffers for long periods, and the individual lacks control over how they feel. This condition could come from the social factors of life whose causative agents attack a person’s psyche. Some of the possible causes are economic, such as the lack of a job in a place with high living expenses, discrimination, crime, and pollution. Stress could be detrimental to health, and at times fatal. Some of the chronic conditions that could result from stress include high blood pressure, insomnia, weakened immunity, and anxiety. Repeated stress exposure leads to obesity, depression and cardiovascular conditions (APA, 2015).

Washington is a highly competitive state with a high standard of living. According to Sperling’s Best Places Website, the cost of living in Washington is higher than the US average by 54%. Its rate of unemployment stands at 7.00 with a decreasing rate of job availability (Sperling, 2015). The cost of education in the state is more than twice the average cost of education in the country. Social pressure comes with trying to balance a good standard of living by working hard and trading one’s health. Overworking leads to increased stress levels and thus unhealthy living, despite the high levels of affluence in the city. On a ranking system featuring America’s most stressed out cities, Washington D.C leads the list. People in D.C work an average of about 40 hours per week. This list was compiled basing parameters such as the commuting time, the cost of living, unemployment rates, crime, population density, and hours worked and the portion of income spent on rent (Nelson, 2015).

Race and ethnicity: the demographic census of 2014/15 show that Washington’s population comprises 50% Blacks, 38% Whites, 9% Hispanics, 4% other races, 3% Asian and less than 1% American Indians  (Stats, 2015). The issue of race in America dates back to years before independence. So much has changed in the United States, but the undertones of racial profiling are present in some parts. Washington still struggles with fighting the vice. It remains one of the places where people look through the racial lens (Hurt, 2011). Consequently, some people are bound to be treated with prejudice and denied certain opportunities because of the color of their skin. Such situations could lead to joblessness or under-appreciation thus causing stress. The people who suffer the most are people of the African descent as they are viewed in the old-fashioned notion of being home assistants.

Income inequality and affluence: It is a fact that Washington is one of the most affluent cities in the United States, and probably the world. The average income for residents is $100,000 per year (Morello & Keating, 2010). Thirty years ago, in the 70s, a CEO took home an income that was 30 times higher that of the normal employees. Today, they make as much as about 300 times more for similar comparison (O’Brien, 2015). House rent and land rates have been on a steady rise, yet there have been cases of racial segregation, income inequality, and high standards of living, all of which combine to make life harder and more expensive for a Washington resident.

However, making a living in Washington is a very lucrative opportunity to save a lot of money from the salary since the residents are not entitled to State income taxes. The huge salaries offered by firms and government agencies make life in Washington very comfortable for the working class despite the high costs of living.

The levels of Education in the state Washington area is among the highest in the United States. On average, five suburb countries in that region have more than half their population with at least a bachelor’s degree. The government and large employer institutions play a huge role in advancing the levels of education for its employees. An increase in the number of degrees or any academic qualifications warranties a pay hike. However, disparities are also exhibited concerning education levels. There is a part of residents who struggle with large debts and survival in the areas with a high standard of living. They struggle with employment, and since the racial lenses still apply, they hardly find satisfying jobs. The level of affluence increases for the rich while the poor are forced to look for cheaper alternative places to live. The levels of education are thus a social pressure that forces people to adapt or live in stress and succumb.

Social capital: The social capital is the value of a person’s social networks along with the mutual inclinations that result from them. The meaningfulness of a social network is determined by the amount of positive impact that it brings to a person. Washington is a city with vast amounts of opportunities. However, it is equally a city of busy businesspeople and professionals who hardly have time to socialize or set aside time for the gym or sports. For this reason alongside ethnic alienation, people hardly expand their social capital within the city. Without expanding the social networks, life might get harder for those seeking opportunities of growth but can hardly catch up with the high costs of living.

In social gatherings, there is a new trend in the major cities where people cling to their phones even when talking to people. In many social gatherings, phones serve to distract social interactive sessions. People can hardly socialize and build networks because there is a barrier posed by the addiction to technology. These situations are stressful and might make someone get into anxiety fits or depression.

Lifestyle: Most of the people living in the Metropolitan area work two or more jobs, for more than 40 hours per week. Most of this time is spent either in front of a computer or a desk for long hours little or no stretching time. Some people get into the habit of ordering instant foods, most of which is junk. Multiple innovative fast-foods companies have provided clients with the option of ordering their meals online and waiting for door delivery. The people adopt the lazy lifestyle and can hardly exercise. They, therefore, become vulnerable to lifestyle diseases such as obesity and diabetes, and the chronic heart conditions. In some instances, the lifestyle that people live, failing to watch their diet, health status, and exercise puts them at the risk of cancer. These conditions often affect people in the huge, busy cities because of the lifestyles they choose to adopt.

Neighborhood characteristics: The kind of places in which one chooses to live determines their health status (Commission Health, 2008). Different surveys have linked socio-economic features of a person’s neighborhood to different conditions such as mortality, disability, health behaviors, chronic conditions, and the general health status.

A person’s character or personality is an average of his/her environment. The environment, in this case, represents the people that surround a person. Children who grow up in areas where people visit the doctor for check-ups regularly are likely to adopt the same culture. In these neighborhoods, the general health status of the community is better compared to neighborhoods that keep overlooking symptoms of medical conditions. Besides, highly qualified medical doctors tend to look for chances to practice in affluent neighborhoods as opposed to rural or “shanty” areas. It means that rich people are more likely to get better medical care since they can afford it.

In Washington, the cost of medical treatment is soaring higher and higher. Only the affluent people can afford the costs of a regular checkup with minor or no symptoms. Conditions that could be treated at a cheaper cost in other places are expensive in Washington area. Such a cap puts a thick line of comfort between the rich and the poor. The positive side of living in affluent areas is that all kinds of medical cases have places for treatment. The character of the neighborhood directly affects a person’s health.

Medical care: Due to the capital availability in this city-state, quality healthcare is accessible, though at high costs. However, there are many healthcare plans that give a reprieve to the Washington residents. The Affordable Healthcare Act (ACA), commonly known as the Obamacare, brings quality healthcare into an affordable zone for millions of American citizens who could not afford comprehensive health insurance policies. The law repealed insurance restrictions that were scrupulous. For example, children get coverage from their parents’ health insurance plan until they are 26. It removes limitations from lifetime insurance coverage, annually payable amount, and denial of coverage for people with pre-existing conditions. The law requires insurance for everyone (Washington HCA, 2015).

The Washington Apple Health is a state and federal government-funded Medicaid plan. The health care plan provides health care medical insurance for those who cannot afford. Out of the 7 million people living in the Washington state, 2 million are covered by the State Healthcare Authority through Apple health and Public Employees Benefits Board (PEBB) programs. With regards to the health situation in Washington State, the citizens are well covered. As a matter of fact, everyone can afford to go for treatment and preventive measures to hospitals for a range of diseases. Washington is thus a healthy state.

Social-economic Factors that Affect Healthcare in Maryland

Chronic stress: Just like Washington, the cost of living in Maryland is higher than the US average. It, therefore, means that people living in this state have to work harder than their counterparts in other states. According to the Sperling’s Best Places Website, Maryland’s cost of living scores 116.10 which is higher than the country’s average of 100 (by 14.10%) (Sperlings, 2015). The rate of unemployment stands at 5.3%, which is lower than the nation’s average (6.30). However, the jobs are decreasing at an annual rate of 0.29%. The cost of education in Maryland is slightly less than double the US average. The average cost of an average home is $57,100, having appreciated by 0.6% in 2014 (Sperlings, 2015). These statistics make Maryland a more affordable place to live in compared to Washington. The rate of unemployment being lower than the nation’s average means that most people afford the costs of living. Consequently, the chances of stress are reduced in this State.

However, since the cost of living is higher than the nation’s average, it becomes difficult for new immigrants and the unemployed to settle. As mentioned before, people work more than two jobs to keep up with the standard of living and be able to save for their sunset years. Maintaining this kind of life balance means that people hardly have time to socialize except at the workplaces, and hence a huge social pressure. Maryland ranks 7th in the most stressed out states in the United States. The fact that people are more relaxed in this area compared to Washington and other more stressed states means that stress-related health conditions are lower than them.

Race and ethnicity: Baltimore is a major economic hub in Maryland. Throughout its history, the coastal city has struggled with racial segregation. In the early 20th century, Mayor Barry Mahool passed a racially restrictive law that barred residents from buying homes in places having racial dominance outside of their own. It was the first apartheid state, forming a culture that has hardly faded. According to Anthony Batts, a Police Commissioner in Baltimore, the city still grapples with the mid-20th Century racism (Puente, 2015).

In response to the various complaints made by Blacks and other minority races, Brian Frosh, the state attorney general, released new police guidelines that restricted them from racial profiling. This action made Maryland the first state to enforce anti-racist policies (Ali, 2015). Racial profiling is an obvious source of social stress since people of certain races are restricted from accessing certain rights silently. Racial profiling denies people the right to mingle freely and chase opportunities within communities.

Income inequality and affluence: Maryland is the richest state in America. According to statistics, a median house received an average of $73,931 for the whole state. A high median annual income coupled with low poverty rates (2nd lowest) signifies equitable resources distribution for its residents. It means that people can interact on a more equitable level than any other states of America (Frohlich & Kent, 2015). From this point of view, health concerns due to stressful conditions are lower. The kind of health issues to worry about arises mainly from the preferred lifestyle.

Social capital: The social capital is a crucial component of an economy’s growth. Due to the racial profiling that has formed part of the characteristic of the State, communities have formed social clubs and communities that constitute racial blocks. For this reason, free mingling and networking are restricted along racial and ethnic lines. As such, the social capital is not exploited to its fullest potential in the communities.

Technology is also a huge barrier in the social places. Most people in the United States are addicted to their smartphones. Most people have developed a habit of checking their phones even when there is no prompt for notification. This habit is a social killer and pushes people away from each other.

Social networking is a national issue that continues to go further from a normalized situation with the increase in communication sophistication. This rising sophisticated technology makes people lonelier in a crowded society, something that could result in anxiety and other psychological implications. According to research, there exists a correlation between one’s degree of loneliness with their mental and psychological health status. People of such kinds will feel less vital, experience longer healing periods, feelings of loneliness at times, increased proneness to depression, and the likelihood to contract diseases like chronic illnesses (Social Wellness, 2015). People spend most of their time working hard to earn a living at the expense of their health, but then realize that their health is too damaged to heal. As a result, they spend most of the assets they earned to try to recover their health.

Lifestyle: People spend most of their time working hard to earn a living at the expense of their health, but then realize that their health is too damaged to heal. As a result, they spend most of the assets they earned to try to recover their health. Maryland is a lively state full of professionals in their vibrant years. The median age for the Maryland residents is 37. It means that people are relatively younger. Since most of the people regard professional progression with high priorities, they will spend most of their lives in school then spend the rest of the active years at the workplace. As a result, people hardly give enough time to exercise and fitness.

Since most people can afford to pay for high-speed internet and food in the fancy fast food joints, they become lazy to walk to restaurants. They will often visit the food joint websites so that they order their junk from the comfort of their offices and homes. Moreover, many children in the state have become coach potatoes and heavy junk consumers. They wait for food, watch television and play video games most of the time before they are 21.

All the issues mentioned are detrimental to one’s health. In this state, the affluence is a bigger problem since it makes people trade their health for the sustenance of the expensive life. The common lifestyle diseases include diabetes, obesity, and cardiovascular diseases.

Neighborhood characteristics: The Maryland neighborhood is safe and relatively stress-free. Known as “America in Miniature,” the State’s topography and get-away sites in the State are breathtaking. It means that people who love nature could call this place home. Fresh environments provide distinctive calm and poise for residents. There is much to enjoy in Maryland, from the peaceful neighbors to lively sports. The NFL brings people of all races together, making them forget their physical attributes. Clean neighborhood and other reasons mentioned above make Maryland a state with relatively high scores on the health index. The high energy in this state coupled with the vibrant young people who care for their profession and healthy families ensures that most people are emotionally, mentally, and psychologically whole.

Medical care:  There are quite a good number of hospitals and healthcare facilities that offer quality, world-class healthcare in Maryland. Three of its 70 hospitals are ranked among the best in the nationally, a position that puts them among the world’s best in the world. John Hopkins Hospital in Baltimore is the best in the State and comes 3rd on the national scale. It has many awards for complicated medical cases that were solved delicately and successfully treated.

There are several medical assistance plans available to residents. First is the Maryland Medicaid Program. It is available for people based on eligibility criteria determined by the state or is medically needy. People who fall between the ages of 19 and 64 qualify for coverage. Single people who have an income of $15,856 and families that make any amounts of income below $26,951 also qualify. For the families and children, there is the FAC (Families and Children) plan for low-income families who need financial assistance. For them, a Temporary Cash Assistance program runs from the State’s fund the medical care reprieve is also available for US immigrants who are legally permanent residents, asylee, refugees, or war veterans who have served in the US Army. The aged, the physically challenged, or the blind and institutionalized persons also qualify for Medicaid.

The Maryland Children’s Health Program (MCHP) provides cover for people under the age of 19 who come from families that make less than 200% of the Federal Poverty Level (FLP). Those who qualify for the MCHP also do so for full Medicaid. Maryland Primary Adult care Program is similar to MCHP, but it is for people above the age of 19. There is also the Family Planning program for women below 51 years who have lost the Medicaid cover due to pregnancy. Patients of End-stage renal disease qualify for the Kidney Disease program (DOHMH Maryland, 2015).

The above list of medical aid available for the residents of Maryland is long enough to show the health index of the state. One can be assured of quality Medical attendance regardless of whether he/she was born in the state or not, provided he/she is legal citizens of the United States of America.

Social-economic Factors that Affect Healthcare in Virginia

Chronic stress: Virginia is the best choice of a home to make a living and to age. While jobs reduced in other States, the rate of employment increased by 1.72%. The rate of unemployment clocks 4.50%, which is well below the US average. The cost of living is just 9% higher than the US average. A median home in the state costs about $232,400, and the tuition fees are below the US average expenditure. All these factors make Virginia a stress-free zone.

People who live in stress-free areas are bound to be healthier than those in other states. In such a case, medical insurance and paid checkups are very affordable for almost all the people in this State. Life in Virginia is good and hence people living in this state are likely to be healthy.

Race and ethnicity: While it might seem like a bed of roses, Virginia has serious thorns for some people. The Northern part of the state is a multi-racial metropolis. However, the Southern part that includes Richmond is very racist. It is one of the few places where the Confederate flag is raised; the KKK club calls it home. This level of racial profiling means that the people of races other than White are unwelcomed to stay. In March 2013, most Latino children attended increasingly segregated schools where there was likely less than 10% White student population (Chandler, 2013).

The facts above show that non-Whites living in Virginia should brace for racial discrimination, despite the fact that it is illegal in the country. Racial segregation has adverse effects on people’s health. Living in highly segregated areas is like constantly getting negative energy, which leads to stress and other psychological conditions such as depression, which often leads to diseases. Racial profiling is a social determinant of health since it results in the fear of discrimination and stress, which are unhealthy.

Income inequality and affluence: The state was classified as the best place to earn a living in 2012. It was relegated to the second position on the list trailing Washington in 2013. What is remarkable about this State is that it offered above average income for employees yet the cost of living fell below the national average (Smith, 2013). The increasing costs of living across America brought its average cost of living just slightly higher than the cost of living in 2015. The cost of living in the state stands at 108.30, making it the cheapest in the tri-state.

Social capital: Racism, ethnicity or chauvinism or any other form of segregation is an enemy to effective social capital value. The strength of the social capital lies in people collaborating to solve problems and alleviate each other’s pains. However, any prejudicial treatment worsens people’s feelings. Grouping according to whatever characteristics is a reaction to the fear of discrimination, and, therefore, the need to want to belong. Such is the case that happens in highly segregated areas, where people of a certain class or attribute feel superior to others. The ones deemed inferior are vulnerable to sickness and physical harm. Considering that Virginia’s index of segregation is high, there are high risks of psychological conditions and weak immunity.

Lifestyle and neighborhood characteristics: Due to the Virginia’s state of affluence, the state is certainly offering the best places to raise a family. First, there are extremely low cases of insecurity. Second, schools are within very affordable ranges for high-quality tuition, and the availability of many hospitals makes living more comfortable. A high number of social amenities coupled with high incomes and low costs of living are a sign that people can get involved in whatever co-curricular activities and socialize over sports. This kind of lifestyle is enviable and stands out as healthy.

Neighborhood and lifestyle determinants of the health include health of neighboring families, income level, and levels of insecurity, availability of social amenities and hospitals, and ability to follow one’s dreams. All of these attributes form part of one’s package in Virginia.

Medical care:  Virginia has 130 hospitals, 4 of which are nationally ranked. Apart from the four, 15 hospitals meet the high-performance national standards. It means that medical care exists for a variety of diseases and conditions that could occur in the United States or any other country on earth.

There are health plans available to the people of Virginia in the form of Medicaid and Medicare. The former is an insurance program for the older people, 65 and above, who have begun to develop chronic medical conditions but qualify for no other medical healthcare plan including the Medicaid. Also, children qualify for an insurance coverage plan that is offered under the FAMIS Plus (VHI, 2015). These are three medical plans that give the reprieve to the people of Virginia; all citizens fall into the three categories; children, adults and the aged.

The social determinants of health are very important since they affect a person directly. Human beings are social creatures who rely on the community for a sense of belonging, admiration, mutual support, and progression. Any social construct that disregards these things threatens people and makes them vulnerable to physical, emotional or psychological disturbance, which lead to poor health. Based on the above analysis, the place that offers the most comfortable and hence healthy lifestyle on the social determinant scale is Washington, followed by Virginia and then Maryland.

Environmental Determinants of Health Disparities

As stated before, one’s environment is crucial to a person’s health; reason being that it determines whatever resources and vulnerabilities to which a person is exposed. A psychological notion that a person is born with an empty slate but the environment shapes whatever kind of people they become is enough to tell the importance of an environment.

Pollution levels: As stated before, one’s environment is crucial to a person’s health; reason being that it determines the resources and vulnerabilities to which a person is exposed. The Washington State has few manufacturing industries that could pollute the environment adversely. There are three major industries that drive the country: Manufacturing, Agriculture, and Energy. Highly Mechanized Agriculture is a stronghold of the state. The farms consume a lot of fertilizer, which puts it at a danger of land pollution, which could eventually turn into water pollution if quality checks are not regularly done. According to the Washington Air Quality Assurance, the main pollutants in the area are particle pollution, ozone, nitrogen, carbon monoxide, and sulfur dioxide.  A psychological notion that a person is born with an empty slate but the environment shapes whatever kind of people they become is enough to tell the importance of an environment. (WAQA, 2015). Any forms of particles found in the air are harmful to one’s health. Washington deals with other forms of non-point pollution, stormwater, oil spillage and industrial waste discharges.

Despite the strict limits on emissions by the United States government, Maryland still gets power from coal. Coal emits smoke after burning. It is a major cause of concern since the smoke is highly toxic (Wheeler, 2012).

In 2012, Virginia featured second for high water pollution levels. Various toxic chemicals from industries are often disposed off to the waterways; 18 million pounds of chemicals. James River had about 1.1 million pounds of pollutants according to a survey conducted in 2010 (wtvrerikaneddenien, 2012).

The high levels of pollution in the tri-state make the residents vulnerable to various respiratory, malignant, and other physical complications. Of the three, Virginia is the worst state in terms of pollution. Despite its gains on the social determinants of health, pollution drags its health index downwards.

Access to clean water: Air and water pollution are significant in determining the health status of a place. However, there are certain checks and balances that could help to reduce casualties of pollution. The quality of drinking water directly determines health in the short and long term since it is taken into the body. Any forms of toxicity or pathogens endanger a person’s health.

The water-handling in the tri-state is sophisticated and ensures that people get access to clean water. This advanced system of water purification comes with the fact that the tri-state houses the most affluent people in the country, and there is high competition and money to provide the best services.

Access to clean water was on the list of the federal government’s plans, which was executed efficiently and successfully. Water-borne diseases, which were a major challenge in the early 20th Century, have dropped to nearly zero cases at the moment (CDC, 2015). The United States of America is one of the places that offer the most efficient clean water distribution systems in the world.

Safety of houses: It is obvious that houses are huge determinants of a person’s or family’s health. Good housing results in the relative calm, which is always absent in the lives of homeless people. Considering the statistics of the rate of unemployment and levels of affluence of the tri-state, the larger majority of residents in the tri-state can afford good houses that offer safety for their families and domestic workers.

Transport systems: The transport system is a major source of pollution. Noise and air pollution get large contributions from the transport system. The tri-state is highly urbanized, meaning that almost every homestead owns a vehicle or more. The emissions from the vehicles constitute carbon monoxide, sulfur, and nitrogen dioxide, which are major air pollutants. The busy airports also produce large decibels of sound. The emissions produced by vehicles have been linked, by volumes of research, to heart problems, asthma triggers, and cancer among other health conditions.

The transport system of urbanized areas makes them a major health hazard. Consequently, living in any parts of the tri-state increases the vulnerability of exposure to disease-causing emissions.

Exposure to radiation: The USA is central to radiation emission tests, as evident from the 20th Century shows. Maryland has recorded toxic radiations from the Japanese reactors in 2011 (Roylance, 2011). Washington and Virginia have recorded very low radiation levels in the recent past. However, due to past activities that involved nuclear reaction in the United States, all citizens of the country suffer a 40% higher chance of contracting, and a 20% vulnerability to death from cancer than other nations in the world (Roylance, 2011).


The above discussion analyzes carefully the social and environmental determinants of health that residents of the tri-state face. There are similarities in some cases, yet distinctive disparities are also visible in both categories of determinants. Concerning the discussion, I find credible reasons to believe that social determinants have a greater impact on the health of individuals in the area than environmental factors. The states have been ranked from various surveys as being either best or worst in certain regards on a national basis in comparison to other states. The area is a prime location of residence, and the decision on which of the three states offers the best life depends on the perspective of a person’s needs. However, one fact is that as long as affluence remains the biggest determinant of a healthy lifestyle, the Tristate remains lucrative as a potential home.


Ali, R., 2015. Maryland First State to Ban Cops From ALL Racist and Discriminatory Profiling. [Online]
Available at:
[Accessed 9 October 2015].

APA, 2015. Understanding chronic stress. [Online]
Available at:

CDC, 2015. Drinking Water Week. [Online]
Available at:
[Accessed 10 October 2015].

CDC, 2015. Social Determinants of Health. [Online]
Available at:

Chandler, M. A., 2013. [Online]
Available at: Latino students attending increasingly segregated schools in Virginia
[Accessed 10 October 2015].

Commission health, 2008. Where We Live Matters for Our Health: Neighborhoods and Health. [Online]
Available at:

DOHMH Maryland, 2015. Medical Care Program Eligibility. [Online]
Available at:
[Accessed 9 October 2015].

Frohlich, T. C. & Kent, A., 2015. America’s Richest (and Poorest) States. [Online]
Available at:
[Accessed 9 October 2015].

Hurt, C., 2011. Racism lives in D.C.’s heart when it comes to redistricting. [Online]
Available at:

Morello, C. & Keating, D., 2010. Washington area is wealthiest and most educated region in the nation, census data show. [Online]
Available at:

Nelson, R., 2015. These Are The 10 Most Stressed Out Cities In America. [Online]
Available at:

O’Brien, M., 2015. [Online]
Available at:

Puente, J. G. a. M., 2015. Baltimore leaders agree: City has a race problem. [Online]
Available at:
[Accessed 9 October 2015].

Roylance, F. D., 2011. On the lookout for radiation in Maryland. [Online]
Available at:
[Accessed 10 October 2015].

Smith, J., 2013. The Best And Worst States To Make A Living In. [Online]
Available at:
[Accessed 10 October 2015].

Social Wellness, 2015. The Impact Of Social Isolation. [Online]
Available at:
[Accessed 9 October 2015].

Sperling, 2015. Washington, District of Columbia. [Online]
Available at:
[Accessed 9 October 2015].

Sperlings, 2015. COST OF LIVING. [Online]
Available at:
[Accessed 9 October 2015].

Sperlings, 2015. Maryland, New York. [Online]
Available at:
[Accessed 9 October 2015].

Stats, S., 2015. Population Demographics for Washington DC 2014 and 2015. [Online]
Available at:

VHI, 2015. Medicare and Medicaid. [Online]
Available at:
[Accessed 10 October 2015].

WAQA, 2015. Washington Air Quality Advisory. [Online]
Available at:
[Accessed 10 October 2015].

Washington HCA, 2015. Health Care Reform. [Online]
Available at:
[Accessed 9 October 2015].

Wheeler, T., 2012. Coal still a major cause of Maryland’s toxic air pollution. [Online]
Available at:
[Accessed 10 October 2015].

WHO, 2015. Social determinants of health. [Online]
Available at:

wtvrerikaneddenien, 2012. Report: Virginia second in nation in water pollution. [Online]
Available at:
[Accessed 10 October 2015].

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