SOCIAL DETERMINANTS OF HEALTH (SDOH)
Southern Berkshire County experiences health inequities that stem from the social determinants of health and are further compounded by the distinct structural and geographic challenges of rural communities.
The SDOH are the conditions in the places where people are born, live, go to school, work, play, practice their faith, and grow older. These conditions shape how healthy people are and influence their overall well‑being. They are community‑level factors, also referred to as system‑level factors.
A person’s Health‑Related Social Needs (HRSN) include the day‑to‑day necessities required to live a healthy life. These necessities include food, housing, transportation, and safety. These individual‑level needs are directly connected to the conditions of the environment where a person lives.
The Five Domains of the SDOH:
Rural Health Disparities
People living in rural areas face several health challenges, including limited access to health care, lower rates of insurance coverage, transportation barriers, and higher rates of poverty. Rural populations often experience worse health outcomes as a result of these challenges. Vulnerable populations, including older adults, individuals with disabilities, and those with limited financial resources, are disproportionately affected.
Rural communities face health disparities made evident by the age-adjusted all cause death rates in rural areas being consistently higher than in urban areas. While the death rate has decreased over time, as of 2019 data from the National Center for Health Statistics, the gap between rural and urban areas had widened.
The social determinants of health both directly and indirectly influence a person’s health outcomes. In South Berkshire County, the following challenges play a particular role in individual’s ability to live a healthy life:
Food Insecurity
According to a the Greater Boston Food Bank's 2024 report, 39% of households in Berkshire County reported food insecurity, as compared to more than 1 in 3 households across Massachusetts (Greater Boston Food Bank, 2024).
Access to transportation
Transportation is a challenge for many residents of Berkshire County. The 2025 Berkshire County Community Health Needs Assessment (CHNA) reported that about 9% of households in the county do not have a motor vehicle, and only 23% of South County residents reported living within 0.5 mile of a transit stop. An additional difficulty of public transportation in the county is that it often does not operate outside business hours, routes are limited, and some routes are indirect.
Housing insecurity
According to the 2025 Berkshire County Community Health Needs Assessment (CHNA), between 2020 and 2023, unhoused families have increased 44% in Berkshire County.
Here at SBRHN, we work with key stakeholders and community organizations to address these gaps and improve health, well-being, and quality of life for South Berkshire County residents.