By Michael O. SchroederU.S. News & World Report

What makes a community healthy isn’t just the luck of the draw.

It isn’t just great genes, either. Health is also a sense of well-being and security, access to a healthy diet, green spaces, recreational opportunities and the like.

These are the so-called social determinants of disease, the social and environmental conditions that we’re born into and encounter as we grow. They include our income, race, where we live or work, and the opportunities we are afforded. All may profoundly affect a person’s health and well-being, says Joel Kaufman, Dean of the University of Washington School of Public Health.

Such deeply rooted factors can tip the scales from health to illness. They can make one community better off than the one next door. Access to quality health care is important as well, potentially affecting obesity rates and variations in risk for stroke and heart disease.

Communities with higher incomes are often healthier, with fewer premature deaths and decreased rates of everything from heart disease, diabetes and stroke to kidney disease and vision trouble. But money, like vaccines, don’t offer perfect protection against illness. Chronic diseases, fueled by inactivity, excessive eating or drinking and other unhealthful behaviors, are common in these communities too.

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