Which social determinants of health have the greatest impact on healthcare spending?

Based on broad health policy research, the social determinants of health that most consistently drive up healthcare spending are housing stability and affordability, access to nutritious food (food security), and fundamental aspects of economic stability like income and education levels. For example, patients facing unstable or unaffordable housing often delay routine care and end up in the emergency room for crises that could have been prevented, directly raising hospital costs. Similarly, food insecurity worsens chronic conditions like diabetes or heart disease, leading to more frequent hospitalizations and longer stays. Lower educational attainment and poverty are also strongly linked to delayed care, poorer disease management, and higher overall spending. While the exact weight of each factor varies by community and patient population, these three tend to have the most concrete, measurable impact on hospital budgets and resource use.