Journey to Addressing the Social Determinants of Health

Health is influenced by many different factors. Genetics and family history play a large role in one’s overall well-being, but environmental factors such as where someone lives, learns, works, and plays, also affect a wide range of outcomes.  These conditions are better known as the Social Determinants of Health (SDoH). The SDoH impact the way clinicians care for their patients, as some treatment plans may not work for certain individuals given their geographic location, financial stability, etc. Below you will find more information about the SDoH and how organizations can address them.

Examples of Social Determinants

The Office of Disease Prevention and Health Promotion (ODPHP) categorized the SDoH into five essential areas which include:

• Neighborhood and built environment
• Economic stability
• Education
• Social and community context
• Health and health care

Neighborhood and built environment: Geographic factors that can negatively impact health include poor air or water quality, lack of nearby healthcare professionals, fast food swamps (surrounded by unhealthy food options), little access to parks or playgrounds for exercise, a sub-par school district with minimal extra-curricular activities, high crime rates and more.

Economic stability: According to a Stress in America survey published in November of 2017, 62% of Americans report being stressed over finances. Gallup reported nearly one-third of American adults held off seeking medical care in 2018 because of cost. On top of physical health, financial stress can be damaging to one’s mental health, as it is linked to an increase in depression and anxiety as well as unhealthy behaviors, such as drinking, smoking, and overeating.

Education: Individuals with a higher education generally have better health outcomes. According to the New York Times, people with at least some college education have mortality rates less than half of those without any college education. When you develop a healthy lifestyle at a young age, it tends to stick with you throughout life.

Social and community context: The number and strength of your relationships can impact both your mental and physical health. According to a recent survey, nearly half of Americans report feeling alone. Loneliness has been associated to depression, high blood pressure, obesity and alcohol and drug abuse. Having a healthy and balanced social life may help reduce stress and heart-related risks, leading to living a longer life. Intimate relationships and physical contact trigger hormones and brain chemicals that not only make us feel great but also have other biological benefits (News in Health).

Health and healthcare: Obviously, the greater access to care, the greater chance one can live a healthy life. Individuals living in rural communities may have more trouble getting in contact with their primary-care physicians, while people living in urban communities have plenty of hospitals and healthcare facilities nearby. Finances play a role in health as well. Those with higher incomes can afford the best medication and treatment while those with lower incomes, might not be able to afford the same care.

How we can address the SDoH

All the SDoH must be considered when developing treatments plans for each patient. Christopher Cheney of Health Leaders Media says providers can use the 5As to address these conditions:

1. Awareness
2. Adjustment
3. Assistance
4. Alignment
5. Advocacy

Awareness: Organizations are aware of these determinants and are beginning to ask patients social risk screening questions before treatment so they can get a better gauge on each patients’ situation.

Adjustment: If a provider’s treatment plans are disrupted due to a SDoH, they must make the necessary adjustments. For example, if a patient cannot go in to see a doctor due to geographic location or time constraints, the doctor could set up a virtual visit/telehealth appointment. If a patient cannot afford a certain drug, the provider could suggest a cheaper alternative.

Assistance: If a patient is struggling with a social or behavioral issue such as depression or addiction, providers should recommend a specialist. Professional counselling is a necessary step in healing the mind and/or body.

Alignment: Instead of opening a new facility across the street from a competitor or one of your alternate health centers, clinicians can start a new practice in a neighborhood that lacks health resources.

Advocacy: By forming alliances with social care organizations, providers can advocate for certain policies that promote additional resources for underprivileged patients. For example, healthcare organizations can call for policy changes regarding transportation services in a certain community. When coronavirus was at its worst, rideshare company, Uber partnered with care facilities to give patients rides to their doctor appointments.

Patient care goes beyond Googling the problem and prescribing the basic remedy. If it were, anyone could do it. The Social Determinants of Health make healthcare very complex, which is why only the most keen, valiant, and compassionate individuals can succeed in it. Sir William Osler once said, “The good physician treats the disease; the great physician treats the patient who has the disease.”

Cantata Health Solutions is committed to finding a solution to social determinants of health and is working on whole-patient-care solutions which includes all aspects of Health and Human Services including food insecurities. We are putting the person in the center and committing to a patient-centric future.

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REFERENCES:

Braveman, P., et al. “Neighborhoods and Health.” RWJF, 1 June 2018.

Cheney, Christopher. “5 Ways Healthcare Organizations Can Address Social Determinants of Health.” HealthLeaders Media, 21 Oct. 2019.

“Do Social Ties Affect Our Health?” National Institutes of Health, U.S. Department of Health and Human Services, 8 Sept. 2017.

Frakt, Austin. “Does Your Education Level Affect Your Health?” The New York Times, 3 June 2019.

Hernandez, Dominic. “Your Social Life, or Lack Thereof, Can Affect Your Health.” Vital Record, 31 May 2019.

Scott, Elizabeth. “How to Cope With Financial Stress.” Verywell Mind, 26 Mar. 2020.

“Social Determinants of Health.” Healthy People , Office of Disease Prevention and Health Promotion, 2020.