Research shows that only 10% of our health outcomes are determined by the health care we receive. Another 10% of how healthy we are is determined by our genetic make-up. What accounts for the rest? This presentation will ask and answer this important question which is key to understanding how to live our longest, healthiest lives possible. We will explore the data that demonstrates that social determinants – the environments in which we live, work, and play – determine our health and health behaviors more than all other influences combined. This discussion will examine these “social determinants of health” from an empirical, medical, and practical perspective. We will focus our attention on the data that describe the health of populations in Virginia, but rely also on national studies that powerfully link social and economic inequity with health disparities. We will end our discussion with a survey of what can be done by citizens, health providers, and policy-makers in light of the evidence.