Social Determinants of Health

How do Social Determinants of Health Affect Patient Wellness.
Different social determinants of health affect patient wellness by limiting patient access to key health and lifestyle resources

By Sara Heath – October 09, 2020 [Excerpts] The social determinants of health garnered a lot of attention once it became evident they can impact value-based care success.

As healthcare providers worked to promote overall health and wellness and to prevent unnecessary healthcare utilization, it quickly became clear that certain social factors were at play here. The social determinants of health could affect whether a patient obtained and maintained wellness, regardless of the quality of care they would receive during a clinical encounter.

To be clear, there is a broad array of social determinants of health that impact a patient’s ability to be healthy. For length and clarity, PatientEngagementHIT has identified the top most common social determinants of health and outlined how they directly impact patient wellness.

The social determinants of health garnered a lot of attention once it became evident they can impact value-based care success.To be clear, there is a broad array of social determinants of health that impact a patient’s ability to be healthy. For length and clarity, PatientEngagementHIT has identified the top most common social determinants of health and outlined how they directly impact patient wellness.

TRANSPORTATION
Transportation has an effect on patient wellness because it directly impacts whether or not a patient can access her healthcare. When a patient has transportation barriers, she is less likely to attend a wellness check, chronic disease management appointment, or follow-up care.

In 2017, 3.6 million individuals missed an appointment because they did not have access to transportation to that appointment, according to figures from the American Hospital Association (AHA). Four percent of children missed their medical appointments for that reason.

HOUSING
Housing, too, has a direct correlation with health and wellness.
 
“Chronic medical problems that are prevalent among adults experiencing homelessness include seizures, chronic obstructive pulmonary disease, arthritis and other musculoskeletal disorders,” Homeless Hub reports on its website. “Conditions such as hypertension, diabetes and anemia are often inadequately controlled and may go undetected for long periods. Respiratory tract infections are common and oral and dental health is often poor.”

What’s more, individuals who are homeless are at higher risk for certain illnesses by virtue of living on the streets or having an unstable housing situation. Tuberculosis, for example, is common among individuals who are homeless, Homeless Hub stated.

INCOME
Income is a pervasive social determinant of health because it has a domino effect on several other social determinants of health. Income can impact:

• Educational attainment

• Healthcare affordability, payer status

• Housing status

• Access to nutritious food

• Numerous other domains

FOOD SECURITY
Food security most prominently affects a patient’s ability to manage or stave off chronic illness. When a patient cannot access nutritious food, it becomes more likely they may develop a chronic disease like diabetes, or become non-adherent to dietary components of a care plan.

UTILITIES STRESS
Utilities stress is defined as challenges in paying for key household functions, like the water bill, electric bill, or heating bill. These utilities are what make a house livable, but payment can be extremely challenging for some populations.

RACE, DISCRIMINATION
Race has long been regarded as a key social determinant of health, with most of the literature indicating that traditionally marginalized populations are more likely to experience other social determinants of health than White patients. Black and Hispanic patients may be more likely to be low-income, for example.

Per 2020 research out of the Regenstrief Institute and Department of Veterans Affairs (VA), Black patients have picked up on non-verbal cues that could suggest implicit racial bias. Factors like a mostly white clinic staff and strained patient-provider communication can get in the way of Black patients perceiving quality healthcare.

Healthcare is also largely understanding racism as a public health crisis. Although the field of understanding is burgeoning, the concept of “weathering” might have a big impact on chronic illness.

Weathering is the idea that prolonged exposure to adverse conditions, like discrimination, can have an impact on chronic illness. The sustained stress could negatively impact patient wellness.

A July 2020 report gives credence to that concept. The American Heart Association found that individuals with reports of discrimination were more likely to develop hypertension.

For the full article, please visit: https://patientengagementhit.com/news/how-do-social-determinants-of-health-affect-patient-wellness

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