Social determinants of health in older adults: Current and emerging challenges

This special issue of International Psychogeriatrics contains 6 original research articles, 2 review articles, and 1 commentary about the social determinants of health (SDoH) in late adulthood.SDoHs are nonmedical variables that influence health outcomes [1], including, among others: education access and quality, early childhood adversities, economic stability, occupational opportunities, income and wealth, access to affordable health care, neighbourhood and built environment, access to clean air and water, housing quality and stability, transportation, environmental exposures, food security, access to nutritious food, social and community context, social connections, racial and ethnic and other forms of discrimination, abuse and violence, incarceration, immigration status, sexual or gender minority status.This Special Issue reflects growing recognition of the impact of environmental and socioeconomic factors on aging disparities, and an enhanced understanding of the role of SDoHs in cognitive and mental health.In this regard, the paper from Liu et al. [2], which explains the bidirectional relationships between SDoHs and adverse childhood experiences (ACEs) is especially illustrative.ACEs refer to traumatic events in childhood, including physical, emotional, or sexual abuse, neglect, or household dysfunction.SDoHs establish the likelihood of ACEs to occur, and ACEs affect mental and physical health and impact the self-reported health (SRH) status across lifespan.Using data from the China Health and Retirement Longitudinal Study, the authors found that middle-aged and older Chinese individuals with more ACEs have poorer SRH, a faster rate of deterioration throughout adulthood, and also found a mediating role of activities of daily living and chronic diseases in this relation.For the authors of this editorial, the data from this study provide powerful arguments for advocating the need for public, universal, and free social and healthcare systems.This observation is facilitated by the fact that we both share extensive research and clinical experience and know firsthand a complex integrated health and social care system like