Step One: Understanding the Social Determinants of Health
How Social Factors Impact Patient Health & Outcomes
Before implementing SDOH screening and other best practices, clinicians need a basic understanding of the social determinants of health
Research on the social determinants of health continues to evolve at a rapid pace. Healthcare organizations, higher education institutions, government agencies, and non-profits have invested a variety of resources to better understand and communicate the importance of SDOH, especially in terms of how it relates to medical care.
What Are Social Determinants of Health?
Social determinants of health are the non-medical factors that influence health outcomes. They include characteristics of the environments where we grow, live, learn, work, play, worship, and age. The conditions in these environments shape our health, well-being, and quality of life.
It is widely accepted that SDOH is comprised of five main categories:
- Education Access & Quality: Graduation rates, language & literacy, and early childhood education & development
- Neighborhood & Built Environment: Housing quality, access to transportation, and community violence & crime
- Social & Community Context: Supportive community, workplace conditions, incarceration, and racism
- Economic Stability: Poverty, employment, food security, and housing stability
- Healthcare Access & Quality: Health literacy, insurance coverage, and access to healthcare
SDOH’s Relationship to Health Disparities & Inequities
What do SDOH barriers look like in reality?
Consider an individual living in a rural Arizona community. The community’s main source of groceries is the local dollar store, which does not stock a wide variety of fresh foods such as fruits and vegetables.
Due to the community’s lack of access to nutritious food, the population is less likely to maintain a healthy diet, even when encouraged by their physicians.
In turn, this increases their risk of developing conditions such as heart disease, diabetes, and obesity, which potentially shortens their life expectancy compared to those in the neighboring town, who have access to healthier food options.
As the case study illustrates, merely promoting healthy choices is not enough to eliminate health disparities and inequities. Instead, public health organizations, along with their partners in sectors like education, transportation, and housing, must take proactive steps to enhance the conditions in people’s environments.
Exploring the Different Social Determinants of Health
Within the five main categories of social determinants of health, there are a broad number of contributing factors, including access to key resources, social supports, and physical safety. Learn more about these factors below.
Access to timely and quality medical care is essential for diagnosing and treating health conditions early. Ensuring that all individuals can access healthcare services leads to improved health outcomes and reduced healthcare costs.
Nutritious foods are the foundation of good health, providing the necessary nutrients for growth and disease prevention. Food insecurity can lead to malnutrition and chronic illnesses, highlighting the need for accessible and affordable healthy food options.
Clean water and functioning utilities are fundamental for maintaining health and hygiene. Lack of access to these basic necessities can result in serious health issues, including waterborne diseases and respiratory problems.
A supportive and enriching early childhood environment fosters healthy development and lifelong well-being. Exposure to positive social and physical environments during early years is critical for cognitive, emotional, and physical growth.
Education and health literacy empower individuals to make informed decisions about their health. Higher levels of education correlate with better health outcomes, as educated individuals are more likely to engage in healthy behaviors and access healthcare services.
Strong social support networks contribute to emotional well-being and can mitigate the effects of stress and illness. Family, friends, and community connections provide a crucial safety net, helping individuals navigate health challenges.
Safe, affordable housing and reliable transportation are vital for accessing healthcare and other essential services. Housing instability and transportation barriers can significantly impact an individual’s ability to maintain health and seek medical care.
Effective communication between patients and healthcare providers is essential for accurate diagnosis and treatment. Language barriers and limited communication skills can hinder access to care and understanding of health information.
Safe neighborhoods promote physical activity and reduce the risk of injuries and violence. Feeling secure in one’s community is crucial for mental health and overall well-being.
Stable employment provides financial stability, health insurance, and access to healthcare benefits. Job insecurity and unemployment can lead to stress, poor health, and limited access to necessary medical care.
Exposure to violence, discrimination, and other adverse social conditions can have profound negative effects on health. Addressing these stressors is key to fostering a healthy and supportive environment for all individuals.
Start Step Two of Implementing SDOH Screening:
With a working knowledge of SDOH under your belt, you’re ready to explore methods of preparing your practice for screening.
Continue Your SDOH Learning
ArMA’s SDOH Center of Excellence offers physicians many opportunities to continue their learning and exploration of the non-medical factors impacting patients. For more resources, including webinars, whitepapers, and more, visit our Resources webpage.