Mental health cannot be fully understood — or effectively addressed — without considering the powerful forces that shape people’s everyday lives. Poverty, racism, and trauma are more than just challenges individuals face; they are deeply embedded social determinants of mental health that influence who receives access to care, who experiences chronic stress, and who is most vulnerable to mental illness.
While the concepts of trauma-informed care and social determinants of health (SDOH) are becoming more widely known among professionals in human services, the intersection of these ideas — particularly as they relate to mental health — requires greater attention.
What Are Social Determinants of Health?
The World Health Organization (WHO) defines social determinants of health as the conditions in which people are born, grow, live, work, and age — conditions shaped by the distribution of power, resources, and opportunity at every level of society. These determinants influence both physical and mental health outcomes across the lifespan.
Social determinants can be thought of as either protective factors or risk factors. Protective factors — such as safe neighborhoods, stable income, and strong social support — help buffer individuals from mental health challenges. Risk factors, on the other hand, increase vulnerability and include experiences like poverty, food insecurity, exposure to violence, and housing instability.
Importantly, these factors are not fixed. A protective factor today, such as stable employment, may become a risk factor tomorrow if that job is lost or becomes unsafe. Understanding this fluidity is essential for building responsive systems of care.
The social determinants of mental health highlight the deep-rooted inequalities in income, education, access to care, physical environments, and social support systems. These factors are often interconnected, compounding their impact on individuals’ mental well-being.
Trauma as a Social Determinant of Mental Health
The landmark Adverse Childhood Experiences (ACEs) Study laid the groundwork for understanding how early trauma — such as abuse, neglect, or exposure to domestic violence — correlates with a higher likelihood of mental health conditions later in life. But trauma doesn’t only happen in childhood, nor does it exist in a vacuum.
Traumatic experiences, especially when prolonged or repeated, can change brain chemistry and structure, disrupting emotional regulation, memory, and even physical health. These effects often lead to increased risk for depression, anxiety, PTSD, and substance use disorders.
Poverty and Mental Health
Living in poverty can feel like a daily mental health crisis. The constant stress of unstable housing, food insecurity, and limited access to healthcare or transportation exerts a mental and emotional toll that many professionals now recognize as a form of chronic, toxic stress.
Research consistently links poverty with higher rates of depression and anxiety. But the relationship is bidirectional: mental illness can also make it more difficult to secure and maintain employment, leading to a cycle of economic instability and worsening mental health. Breaking this cycle requires upstream interventions that go beyond clinical care.
Racism and Racial Trauma
For many communities of color, racism is not an isolated incident — it is a persistent, systemic force. From discriminatory housing practices to biased policing and healthcare inequities, racism contributes to chronic stress and race-based traumatic stress, often known as racial trauma.
This form of trauma can lead to PTSD, especially when paired with socioeconomic disadvantages. Black and Latino Americans, for example, have higher rates of lifetime PTSD compared to white Americans.
What Can Human Services and Behavioral Health Organizations Do?
To effectively support individuals living at the intersection of poverty, racism, and trauma, behavioral health organizations must take a holistic, trauma-informed, and equity-centered approach. Here’s how:
Advocate for Economic Stability: Support policies that provide income support, housing assistance, and food security. Economic relief is mental health care.
Build Community Resilience: Foster safe, connected environments by investing in youth mentorship, after-school programs, and trauma-informed community initiatives.
Practice Cultural Humility: Move beyond cultural competence to embrace cultural humility — actively acknowledging and addressing power imbalances, systemic bias, and ongoing learning in service delivery.
Collaborate Across Systems: Partner with healthcare providers, schools, and justice systems to address the root causes of trauma and connect individuals to comprehensive support networks.
Strengthen Protective Factors: Empower individuals by highlighting resilience and providing opportunities to build coping skills, self-efficacy, and social support.
Final Thoughts
Mental health disparities will persist unless we address the factors that shape mental well-being. Poverty, racism, and trauma are not separate issues — they are interconnected realities that demand integrated, systemic responses. By aligning trauma-informed care with a deep understanding of social determinants, we can move closer to mental health equity for all.
Jordan Baker is Content Marketing Manager at Relias. Jordan is passionate about e-learning and helping learners achieve their goals. At Relias, he works with subject matter experts across disciplines to shape healthcare content designed to improve clinical practice, staff expertise, and patient outcomes.
Relias provides lifelong workforce enablement solutions for more than 11,000 healthcare and human services organizations and 4.5 million caregivers to drive measurable outcomes. Customers use Relias solutions to attract and retain talent, elevate care quality and reduce risk with our technology, services, community, and expertise.
