Social determinants of health equity for people with pain: from understanding to action.

Objective: This article explores the role of social determinants of health in pain care, highlighting their contribution to health inequities and offering strategies for clinicians to respond to these factors in clinical practice. Methods: This clinical update aligns with the 2025 IASP Global Year, which focuses on pain management and education in low- and middle-income countries, as well as low-income settings and priority populations in high-income countries. Results: Social determinants of health-defined as the social, economic, and environmental conditions shaping people's health outcomes and care experiences-follow a social gradient, and disproportionately affect those facing disadvantage and multiple forms of marginalisation. They play a central role in creating health inequities, which are systematic, avoidable, and unfair differences in health between groups. Social determinants of health are upstream influences that create downstream impacts, including individual social risk factors and health-related social needs. Addressing these influences in pain care requires a multi-level approach that considers broader structural conditions alongside individual contexts. Clinicians can take meaningful action by screening for social factors, tailoring care to individuals' social needs, connecting patients with resources, establishing links within and outside the healthcare system, advocating both at the individual and system level, and critically reflecting on their biases, social identity, and the structural forces that shape health. Conclusion: Social determinants of health are central drivers of disparities in health outcomes and pain care. Although clinicians alone cannot address structural injustice, they play a crucial role in recognising and responding to social conditions that influence care, especially for those most affected by inequities.