Social Drivers of Health & Creative Youth Development
By Denise Montgomery · Guest Editor · Issue 3
The World Health Organization (WHO) defines Social Determinants of Health as: "The conditions in which people are born, grow, live, work and age," which are, in turn, "shaped by the distribution of money, power and resources at global, national and local levels."
Many leaders now use the term Social Drivers of Health to emphasize that these conditions are not fixed fates, but active forces that can be steered (Golden et al., 2024).
This matters, because WHO reports that medical care accounts for only about 10% to 20% of the modifiable contributors to healthy outcomes. It is non-medical factors — the social drivers of health — that account for the remaining 80% to 90% of health outcomes (Commission on Social Determinants of Health, 2008).
Disparities in social drivers fuel health inequities — and offer a profound opportunity for positive change.
Understanding the social drivers of health recasts the global ecosystem of extended education as vital infrastructure for well-being. It suggests that out-of-school time (OST) environments can act as primary engines of resilience. They are part of the community conditions necessary for health and well-being to shift from being a theoretical goal for young people to a lived reality.
How Creative Youth Development Addresses Social Drivers
Social Connection & Belonging
CYD programmes promote protective factors such as peer connection and belonging. As part of a creative community of practice, youth build strong social bonds that counteract isolation and improve mental health outcomes, including reduced anxiety and depression.
Safe & Vibrant Environments
CYD programs foster dialogue around difficult issues and raise mental health awareness — building the foundational safety and inclusivity youth need to thrive. Transforming spaces through youth-led creative projects also generates an enhanced sense of community, as well as physical and psychological well-being.
Agency & Identity Formation
Creative expression is a key aspect of how young people process experiences and explore their identities. CYD programmes drive health by supporting this expression. They can also provide a sense of meaning and agency — often helping youth move from participants to leaders who shape their own environments.
Healthcare Integration & Access
Because out-of-school time (OST) contexts have lower barriers than clinical systems, they reach youth who currently lack access to formal services. These programs act as hubs, creating the referral pathways needed to connect young people with clinical and community resources.
About the Author
Denise Montgomery is a cross-sector strategist, researcher, and leader in creative youth development. She is the founder of CultureThrive and the Global Centre for Creative Youth Development™, and the guest editor of this double issue of Extensions.
More at globalcentreforcyd.org.
References
Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. World Health Organization.
Golden, T. L., Ordway, R. W., Magsamen, S., Mohanty, A., Chen, Y., & Ng, T. W. C. (2024). Supporting youth mental health with arts-based strategies: A global perspective. BMC Medicine, 22(1), 7.
