Social, Cultural & Economic Factors

Social Factors

The people around us have a powerful influence on our health and wellbeing. Social factors include the quality of relationships, whether a person feels included or excluded, and whether they experience bullying or discrimination. These factors can have positive or negative effects across all areas of PIES.

Supportive and Unsupportive Relationships

Supportive relationships with friends, family, peers, and colleagues provide encouragement, practical help, and a sense of belonging. A person who feels supported is more likely to have high self-esteem, manage stress effectively, and maintain good mental health. Family support can encourage healthy eating and exercise, while supportive friendships provide emotional comfort and social opportunities.

Unsupportive relationships have the opposite effect. If a person’s family is critical, neglectful, or abusive, it can lead to low self-esteem, anxiety, depression, and social withdrawal. Unsupportive relationships at work can cause chronic stress, reduced motivation, and difficulty concentrating. Children who grow up without stable, loving relationships may struggle with emotional regulation and forming healthy relationships later in life.

Key Fact

Supportive relationships positively affect all PIES areas: physical (encouragement to stay healthy), intellectual (motivation to learn), emotional (security, self-esteem), social (sense of belonging). Unsupportive relationships have the opposite effect across all areas.

Social Inclusion and Exclusion

Social inclusion means being part of a group or community — feeling accepted and valued. It supports emotional wellbeing by giving a sense of purpose and belonging. Social exclusion means being left out. It can happen because of poverty, disability, language barriers, age, or other factors. Excluded individuals may experience loneliness, depression, and reduced access to services, education, or employment opportunities.

Bullying and Discrimination

Bullying is repeated behaviour intended to hurt, intimidate, or control another person. It can be physical (hitting, pushing), verbal (name-calling, threats), or cyber (online harassment). Bullying severely damages emotional wellbeing, causing anxiety, depression, low self-esteem, and in extreme cases, self-harm. It affects intellectual development through reduced concentration and school avoidance, and social development through isolation and fear of others.

Discrimination means treating someone unfairly because of a characteristic such as age, disability, race, gender, religion, or sexual orientation. It is protected against by the Equality Act 2010. Discrimination in the workplace can limit career progression and income. In healthcare, it can prevent people from accessing the services they need. Experiencing discrimination damages self-esteem, creates stress, and can lead to social withdrawal and poorer health outcomes.

Cultural Factors

Cultural factors relate to the beliefs, values, and practices of the communities people belong to. They shape behaviours and attitudes that can positively or negatively affect health and wellbeing.

Religion: Religious belief can provide a strong sense of community, moral guidance, and emotional support through prayer, worship, and fellowship. However, some religious practices may restrict access to certain medical treatments (e.g. blood transfusions) or create conflict if an individual’s beliefs differ from their family or community.

Gender roles and expectations: Traditional gender roles may limit opportunities — for example, expecting women to be primary carers can restrict career progression and financial independence. Pressure on men to be “strong” and not show emotion can prevent them from seeking help for mental health problems.

Gender identity: An individual whose gender identity does not match the sex they were assigned at birth may face discrimination, bullying, or rejection from family and peers. This can severely affect emotional wellbeing and mental health. Acceptance and support have the opposite, positive effect.

Sexual orientation: Individuals who identify as LGBTQ+ may experience discrimination, prejudice, or bullying, which negatively affects emotional and social wellbeing. In supportive environments, being able to express one’s identity freely has a positive effect on self-esteem and social inclusion.

Community participation: Being involved in community activities (volunteering, clubs, religious groups, sports teams) provides social connections, a sense of purpose, and opportunities for physical activity. It can improve all areas of PIES. Lack of community participation can lead to isolation and loneliness.

Economic Factors

Economic factors relate to money, employment, and financial resources. They have a significant impact on an individual’s ability to access the things needed for good health and wellbeing.

Employment situation: Having a job provides income, routine, social interaction, and a sense of purpose. These positively affect all PIES areas. Unemployment can lead to financial hardship, loss of routine, reduced social contact, low self-esteem, stress, and depression. Long-term unemployment is strongly linked to poor mental and physical health.

Financial resources: These include income (from employment), inheritance, and savings. Having adequate financial resources allows a person to afford nutritious food, suitable housing, heating, healthcare, and leisure activities. Poverty restricts access to all of these, increasing the risk of poor diet, cold or damp housing, stress, and social exclusion. Research consistently shows that people living in poverty have poorer health outcomes and shorter life expectancy than those who are financially secure.