The pandemic is a public health wake-up call, bringing health disparities to light. The data is clear: COVID-19 has a disproportional impact on communities of color and those living in poverty. As a result, the world’s glaring health inequities and the ways that social determinants of health (SDOH) impact patient outcomes have received more attention.
For instance, those living in crowded spaces or shelters have higher viral transmission rates. Others may not have funds for prevention or early detection, time off work for testing or early intervention. In fact, growing research suggests SDOH are the primary cause of care gaps leading to health inequity.
Understanding SDOH can serve as a framework for health professionals to revamp public healthcare systems. William Paterson University’s online Master of Public Health program helps individuals develop critical skills in SDOH and communal wellness.
What Are SDOH?
According to the U.S. Department of Health and Human Services (HHS) Healthy People 2030 page, SDOHs are “conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” HHS groups SDOH into five domains, and the Kaiser Family Foundation (KFF) added the food category:
- Economic stability: employment, income, expenses, debt, medical bills, support
- Neighborhood and physical environment: housing, transportation, parks, playgrounds, walkability, zip code/geography
- Education access and quality: literacy, language, early childhood education, vocational training, higher education
- Food: food security, access to healthy options
- Community, safety and social content: social integration, support systems, community engagement, stress, exposure to violence/trauma, policing/justice policy
- Health care access and quality: health coverage, provider and pharmacy availability, access to linguistically and culturally appropriate and respectful care, quality of care
What Are National Health Equity Initiatives?
Experts agree that healthcare must shift from its current focus on illness to a commitment to wellness. Community well-being requires the provision of basic needs — such as healthy food choices, adequate transportation, safe living spaces and outdoor play areas — which can significantly impact health outcomes.
An interdisciplinary approach is critical to developing strategies across the healthcare continuum from community health to end-of-life. The National Academy of Medicine and other organizations note the need for a more robust, diversified workforce to address health inequities and improve population health and well-being.
What Are Some High-Priority Areas to Improve Health Equity?
Low personal health literacy (HL), psychosocial distress and low socioeconomic status (SES) are among the other primary factors that perpetuate for healthcare disparities. Therefore, focusing on these three areas can help close the gap in health inequalities.
- Low health literacy (HL): People with low HL can have problems navigating a complex healthcare system and understanding medication or provider instructions. Keep in mind that low HL may not correlate with lower education or language barriers; even a highly educated person can have difficulty understanding health terms during times of stress. All professionals can assess for low HL “red flags” and learn about plain language and teach-back methods to help improve population health.
- Psychosocial distress: Distress arises from the physical, emotional, spiritual and practical needs of the individual and their support system or community. These psychosocial issues may compound existing SDOHs and vice versa. For example, if someone must choose between paying their electric bill or buying medicine, they will likely decide to keep the lights on and the refrigerator running. Preventive care aims to proactively anticipate rather than react to patients’ needs, which is critical to improving community health and decreasing distress.
- Low socioeconomic status (SES): Low SES often refers to an individual or group of people with a combination of limited education, income and occupation prospects. People with low SES are more likely to be uninsured, underinsured or Medicaid recipients who often do not routinely seek healthcare. If they do, it’s often via an emergency room. In addition, if they cannot afford healthy food choices, they have more health problems. If they lack transportation or time off from work, they do not seek medical care. In this sense, social determinants of health compound on one another, and healthcare professionals must work with community stakeholders to break this vicious cycle.
Social determinants of health deserve serious consideration because of their impact on public health and patient outcomes. Gaining awareness of SDOH can better prepare public health professionals to improve the quality of life and health conditions for people and communities.
Learn more about William Paterson University’s online Master of Public Health program.
