Which statement illustrates how social determinants influence a health outcome?

• A. Housing instability has no impact on asthma.
• B. Food insecurity improves diabetes management.
• C. Housing instability can worsen asthma control due to exposure to mold or pests.
• D. Access to recreation has no effect on chronic disease.

Answer: (C)

Social determinants of health include the conditions and environments in which people live, which can directly shape how well a disease is managed. Housing instability can worsen asthma control because unstable living situations often expose individuals to asthma triggers like mold and pests. Mold spores irritate airways, and pests such as cockroaches release allergens that can provoke inflammation, making it harder to keep asthma under control. Additionally, unstable housing can disrupt routines, reduce consistent access to medications and healthcare, and increase stress, all of which can lead to poorer asthma management.

Other statements miss the real link between living conditions and health outcomes. For example, housing instability is not harmless to asthma; it can create environmental risks that worsen symptoms. Likewise, food insecurity tends to complicate diabetes management rather than improve it, through stress, inconsistent meals, and barriers to purchasing healthy foods. And access to recreation often supports physical activity, which is important for chronic disease management, so saying it has no effect would overlook its potential benefits.