March 22, 2022  |  Lynn Schear

Social Determinants of Health: A unique story behind every patient

Healthcare has always been focused on patient outcomes. However, with the recent shift toward more patient–centered care, the industry is finding that several factors that influence health are found beyond a patient's medical record. The reality is, barriers to basic needs, such as adequate housing, general education and access to healthy foods, all possess huge implications for healthier outcomes and general well–being.

What are social determinants of health (SDoH)?

The World Health Organization (WHO) defines social determinants of health as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” In other words, SDoH comprise nonmedical factors and drivers that shape the conditions of daily life while highlighting health inequalities in communities across the world.

Health.gov and the CDC state that SDoH can be grouped into five main categories, with a potential sixth category to consider.

1. Education access & quality – literacy, language, early childhood development, higher education and vocational schooling.
2. Healthcare & quality – health coverage, quality of care and access to providers and pharmacies.
3. Neighborhood & environment – housing, transportation, geography and access to parks and playgrounds.
4. Social & community – social support systems, community engagement, stress and anxiety, exposure to violence (trauma) and policing.
5. Economic health – employment, household income, expenses, debt, medical billing and others.
6. Food health/nutrition – food security, access to healthy options, nutrition counseling.

For example, someone who doesn't have access to transportation most likely won't have access to grocery stores with healthy food options. As a result, that person probably won't get the nutrition they need from quality foods. That environmental chain reaction then raises the risk of future health conditions such as heart disease, diabetes and obesity. So, even though it's not a medical condition on their record, SDoH scenarios like this can play a large part in a person's overall wellness, or lack thereof.

It's also important to note that SDoH aren't just limited to individual patients but affect the greater community level as well. While one member of a community might have a well–paying job and adequate housing, another member of that same community may be unemployed and homeless. It's up to healthcare providers and human resources organizations to work together to combat the inequalities of SDoH and improve overall health outcomes for patients and their communities everywhere.

How do we address SDoH in the healthcare industry?

Social determinants of health have become a large point of emphasis in recent years because as more research is conducted, it's become clear that SDoH can be just as important, if not more so, than healthcare or lifestyle choices that influence an individual's well–being. In fact, research shows that SDoH account for between 30%–55% of health outcomes.

But why the sudden spotlight on SDoH if the inequalities have always been prevalent?

Well, as healthcare delivery has shifted more to the home in recent years, due to both the COVID–19 pandemic and technology improvements, it has shed a more in–depth look into the lives of patients everywhere. From the larger community they live in down to their individual health behaviors, including diet, exercise, alcohol consumption, cleanliness and more, each of these factors comes into play.

That's why effective change to address SDoH needs to come at both the community and individual levels. It starts with healthcare providers and human services organizations working together to improve health equality. It's critical to assess the whole person outside of what their medical record may say and incorporating that insight into care plans that involve all parties and community players to achieve success

• Improving provider–patient relationships – openly discussing social factors and understanding a patient's realities and constraints, including things like stress, and lack of transportation or childcare options, anything that can hinder following through on a care plan.
• Leading with trust and connection – clinicians should strive to be stewards of providing trusted advice, having conversations around medical and social needs and empowering patients to follow an effective care plan.
• Offering communication and implicit bias training – everyone has unconscious biases that affect our reflexive attitudes, judgements and decisions when dealing with others. Implementing training for how to deal with these biases can help discourage disparity and inequality in care.
• Encouraging proactive health versus reactive care – healthcare shouldn't be treated as a temporary fix when someone is sick, but rather a lifelong plan of general well–being. That means taking into consideration a patient's medical record and outside SDoH drivers to complete a holistic view of patient health.

There's never been a better time than now to implement SDoH into whole–person care plans because every patient is a person and every person has a unique story.

How can MCH help improve understanding around SDoH?

While leading the charge for SDoH rests heavily on the shoulders of our health system, we all have a part to play in supporting its success.

That's why at MCH, we stand by our targeted and accurate data to help put some of the SDoH puzzle pieces into place. For example, our quality residential care data can help improve the outreach and future care for older generations as the “silver tsunami” of aging baby boomers continues to put added pressure and urgency for proactive care on our health system and senior living facilities.

Additionally, our data coverage efforts to put more professional development experts in touch with clinicians and specialists can help indirectly target ways to support more widespread mental health initiatives. By casting a bigger outreach net, we can help increase awareness and get more of those who are seeking help in touch with the right care team.

We can also help provide smaller rural health systems with the data and equipment they need to provide a similar quality of care experience as that of larger health systems, easing the health inequalities and access to care for small town USA.

And a final example – but certainly not the last – our near century of expertise in the education data market can aid social workers, educators and care teams in pinpointing and helping to bridge the inequality gap in both the quality of and access to education categories. Our data and insights could even play a role in helping to implement better nutrition plans and healthier cafeteria offerings for children in K–12 schools across North America.

Tell us, what's your biggest SDoH concern and how do you think it can best be treated so we can all enjoy a healthier tomorrow?