Social and environmental determinants of occupation: An intersectional concept focused on occupational justice and participation

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ABSTRACT Although there is a focus in occupational science (OS) and occupational therapy (OT) research on social, policy, and physical issues that limit participation, there needs to be continued emphasis on populations and global worldviews. I propose the identification and use of the concept of social and environmental determinants of occupation (SEDO) to examine the complex issues that influence people’s experience through an intersectional lens and affect their access to participate in culturally meaningful occupations. SEDO are defined as broad (and intersecting) social and environmental factors that increase or limit an individual, community, or population’s participation in culturally meaningful occupations of their choice. Unique to SEDO and supported by OS and OT research and practice is the consideration of intersectionality, or how these global factors intersect in a multiplicative manner to influence participation. The discussion highlights health and non-health related examples of the ways intersecting SEDO identify disparities and occupational injustices that affect access to occupations for populations who experience these injustices. The need for continued research and consideration of proposed SEDO is imperative to further OS research, OT practice, and education supporting occupational justice through program and policy development and advocacy. In addition to the effect on research and practice, these considerations provide a strategy for occupational scientists and occupational therapists to monitor and evaluate the impact of policies and programs developed to address these issues and increase participation in culturally meaningful occupations for marginalized populations.