Social determinants of health include which of the following factors that can influence behaviors perceived as noncompliant?

• A. Transportation
• B. Literacy
• C. Trauma history
• D. All of the above

Answer: (D)

Social determinants of health are the conditions in which people live and the broader systems that affect access to care. Transportation, literacy, and trauma history are all examples of these factors that can shape how someone engages with health recommendations. When someone doesn’t follow a plan or misses an appointment, it isn’t always about willingness; it often reflects barriers like not being able to get to care, difficulty understanding instructions, or distrust rooted in past experiences. Transportation can limit clinic access and medication pickup; limited literacy can lead to misinterpretation of dosing or directions; a trauma history can affect trust and comfort in interacting with healthcare providers. Because all of these contribute to how people interact with care, they can influence behaviors that are perceived as noncompliant, making “All of the above” the most accurate answer. Addressing these barriers—offering transportation support, using plain language and teach-back, and approaching care with trauma-informed sensitivity—helps patients engage more effectively.