The weight of the world
Exploring the often overlooked impact of social and environmental factors on health
As we’ve been discussing in this 4-part series, as a psychotherapist, I utilize the biopsychosocial model to better understand the complexity and nuance of the human experience. It encourages us to explore health and healing through a multi-dimensional lens: one that accounts not only for what's happening in our bodies (biological factors), but also what we carry in our minds (psychological factors), and how we’re shaped by the world around us (social and environmental factors).
So far in this series, we’ve:
Introduced the biopsychosocial framework and how it can shift our understanding of health (article 1)
Zoomed in on the biological factors, including hormonal shifts, neurochemistry, and more (article 2)
Explored psychological factors such as beliefs, trauma, coping patterns, and emotional health (article 3)
Now, we arrive at the final—and often the most overlooked—component of the model: social and environmental factors. These are the broader contexts in which we live, work, and connect. And they matter. A lot.
Rarely is any mental health issue we're navigating purely due to ONE factor, often it's a culmination of variables from three areas: biological factors, psychological factors, and social factors (see below for how they all overlap).
Why Social and Environmental Factors Matter
You might be surprised to learn that the World Health Organization (WHO) estimates that the social determinants account for an estimated 30–55% of health outcomes (Vo et al., 2023). That number alone is a wake-up call.
These determinants include access to appropriate care, socioeconomic status, work environments, cultural background, social support, and experiences of discrimination. They also encompass the chronic stress many individuals face due to living in marginalized bodies or under inequitable conditions.
Understanding these factors allows us to shift from a blame-focused approach ("just try harder") to one rooted in context, compassion, and advocacy.
What Are Social and Environmental Factors?
Here are some of the major social/environmental influences that shape our health:
Access to care: Includes proximity to services, financial barriers, and cultural or systemic obstacles that limit access.
Marginalized identity: The impact of living in a stigmatized or oppressed body (e.g., BIPOC, LGBTQ2IA+, neurodivergent individuals, disabled folks, larger-bodied individuals, and those of lower socioeconomic status).
Work culture and stressors: Toxic work environments, lack of boundaries, or unsupportive leadership significantly impact mental and physical well-being of workers (Monteiro & Joseph, 2023).
Socioeconomic status: Financial insecurity increases stress and limits access to health-supportive resources.
Cultural influences: Our cultural background may shape how we understand and seek care (Shenoi & Prabhau, 2013).
Family dynamics and early environments: Intergenerational trauma, family systems, and attachment patterns can deeply influence health over time (Wood et al., 2021).
Relationships and social support: The presence (or absence) of meaningful connection is a key predictor of health outcomes.
Grief and trauma: These lived experiences ripple through all layers of our health and can be compounded by lack of support or validation.
Understanding Allostatic Load
One concept that ties many of these influences together is allostatic load: the cumulative physical burden that chronic stress places on the body. When we live in persistently stressful environments or carry chronic worry about safety, acceptance, or access, our stress response system doesn’t get a chance to reset.
This can lead to:
Elevated cortisol levels
Disrupted immune function
Greater risk for chronic disease
Mood disturbances like anxiety, depression, or emotional exhaustion
(nerd out here)
Allostatic load reminds us that stress isn’t just “in the mind.” It lives in the body—and our environments can either buffer or exacerbate that load.
When Systems Create Stress: A Closer Look
Consider this: individuals living in larger bodies who experience weight stigma report higher levels of perceived discrimination, which doubles their 10-year risk of developing high allostatic load (Tomiyama et al., 2014; Vadiveeloo & Mattei, 2017).
This isn’t about self-discipline or motivation. It’s about recognizing how systemic oppression—whether based on size, race, ability, gender identity, or economic status—gets under the skin and alters our biology over time.
This is particularly important for those navigating healing in contexts where access, safety, and affirmation have never been guaranteed.
Why did I call out this specific marginalized identity? Because many of you who follow me did so initially because of my focus on body image/ disordered eating. And this is a BIG factor we need to be considering in the conversation of healing our relationship with body/ food/ movement. And just to close the loop once more in this series, this is a challenge faced by many women in the perimenopausal period.
What Can We Do? Turning Awareness Into Advocacy
It’s been my personal and professional experience that simply having an awareness of the many factors out of our control can lead to a sense of relief in many ways. It’s what I often refer to as the magic of sense-making that can be such a big part of therapy (when the experiences and factors impacting your life are given context and thus greater clarity).
That said, sometimes the awareness of these factors comes with other emotions. Sadness, hopelessness, deflation, frustration, anger, or even rage. And I want to validate all of those emotions. Because they’re real, and they make sense too.
What I have found personally helpful is to allow those emotions to be present, and then, especially when anger is present, channel it into advocacy. Because advocacy, whether personal or collective, helps us reclaim some of our hopefulness, some of our agency, and power. It’s not perfect, and change takes time, but it’s a proactive step we can take (and sometimes that alone feels good and empowering).
Ways to start advocating:
Seek out supportive, bias-aware care. Look for providers who work from inclusive, trauma-informed frameworks.
Set boundaries where needed. This may mean renegotiating relationships or reevaluating environments that contribute to harm.
Use your voice. Whether in conversations, community, or policy—challenge harmful narratives when you can.
Model the change you wish to see. Advocacy doesn’t always need a megaphone; it can start with how we show up in our own spaces.
Reflections for Integration
As you consider your health, take a moment to reflect:
How do social or environmental factors influence your mental and physical well-being?
Can you offer yourself compassion for what is beyond your control?
Where might small shifts in your environment—or how you respond to it—create more support?
How might advocacy be a form of healing?
Onward in thriving,
Gillian
PS. stay tuned for a NEW series theme starting NEXT week.
PPS. do you have a theme/ topic you’d like me to discuss? I’d love to hear from you. Comment above OR email me at gillian@superyou.ca