This term refers to non-medical factors that affect health outcome. World Health Organization has clearly identified 10 social determinants of health including food, work, addiction, transportation, social class, unemployment, social exclusion, stress, nutrition and education. Some are circumstances in which people are born, grow up, live and work in. These factors are important when addressing health disparities to improve health outcomes. For example, social gradient of the poor have higher mortality and morbidity rates!
The drivers for this inequalities would include unequal economic growth, unequal access to social support resources. Every aspect of the economy can affect health equity, education, housing , finance, employment , nutrition and transportation and thus, economic development is critical to address all above challenges!
For example, obesity has become a real public health problem which is largely preventable by ensuring access to sustainable adequate nutrition, food safety, physical activity participation, ban advertisement for high sugar, salt and fat food targeting children at their favorite TV program. Black infant mortality was 2.3 times higher that white infants in 2015 as black kids were born in poor rural communities.
These factors have to considered when promoting health and wellness for someone who is having financial hardships, unemployed with poor housing. This person needs immediate financial relief to improve living conditions first before talking about physical activity, nutrition and smoking cessation.
Policy makers recognize the impact of social determinants on health outcome. CHRONIC Care Act 2018 expanded coverage for Medicare Advantage to include the Non-medical interventions benefits including transportation for medical appointments and improve accessibility by adding wheel chair ramp or hand rails. For example, in North Carolina , Medicaid beneficiaries were screened for housing suitability, safety, food security to help patients seek social benefits based on the results of the screening. Subsequently, patient medical records can be electronically shared to address specific counseling that the patient needs. For example, choice of appropriate food for diabetic patients through ( Connected Communities of Care) can be coordinated.
There are many healthcare Challenges in the US when compared with western countries or Japan when it comes to having shorter life expectancy, higher degree of income inequality, lowest insured rate affecting Americans with lower income. Those folks are less likely to be in good health compared with those of high income. The uninsured adults are much more likely to go without any any regular medical care due to cost pf insurance which they can not afford. This will end up with higher Cardiovascular disease burden, higher obesity burden especially among low -income Black and Hispanic women with more sedentary life style.
US has higher disease burden with liver cirrhosis due to alcohol abuse and drug abuse than other comparable countries. Poisoning, car accidents and falls are the leading causes of accidental death as well as the highest rate of productivity-years lost due to disability and premature death due to Firearm assaults.
Therefore, improving social determinants of health by fighting poverty, improving access to resources will lead to better healthcare of the community. To address the root cause of the problem rather than addressing the symptoms of the illness. This will be translated to much better health outcome with less healthcare costs spent especially on chronic diseases!
