Evaluating the Impact of Economic Stability and Education on Health Outcomes and Health Equity: A Multilevel Analysis of Social Determinants of Health

This study examines how individual and community-level factors affect health outcomes and equity across four selected communities in Akwa Ibom State. Despite its numerous health reforms, inequities in health outcomes persist in Nigeria, largely driven by education and socio-economic disparities. Thus, this study examined how educational attainment and economic stability affect health outcomes and equity across four communities in Akwa Ibom State. Across-sectional survey of 386 adults and multilevel statistical techniques were used; the analysis assessed individual and community-level interactions. The study draws on the Contextual Determinants of Health Equity Model (CoDHEM) to highlight structural and relational inequalities. Results showed that lower education and income were strongly associated with poor health, but these effects were moderated by community context. Urban areas like Uyo recorded higher clusters of inequity, indicating hidden vulnerabilities. Multilevel analysis revealed that contextual barriers often dilute personal advantages. The study recommends targeted investments in education, income-support programs, and community-based health infrastructure. These findings support the need for equity-focused, place-based health policies to address the root causes of disparity.