“Social determinants of health” (SDOH) are broadly defined as “conditions in places where people live, learn, work and play that affect a wide range of health and quality of life risks and outcomes.”
The past month has been extremely challenging for millions of Americans regarding SDOH given the significant weather and energy issues. Texas was particularly hard hit as millions of Texans faced severe power outages and / or water supply problems due to freezing temperatures and problems generating power. Leaders are trying to restore the lives of millions of those affected, including providing community supplies such as basic food and water supplies, housing people affected by flooded homes, and other resources as needed.
President Joe Biden passed a disaster declaration for the state of Texas last week, in which federal government resources are made available to those affected. The statement said, “Assistance may include grants for temporary home and home repairs, low-cost loans to cover uninsured property damage, and other programs to help individuals and business owners recover from the effects of the disaster.” President Biden will also expected to visit Texas in the coming weeks as relief efforts begin.
SAN ANTONIO, TX – DECEMBER 13: US President Joe Biden speaks at a community event during … [+]
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Unfortunately, this experience has provided the world with another important case study on the value of treating SDOH. When Texans and other Americans across the country quickly found themselves in an uncontrollable situation, all measures for good health went out the window. With no electricity, heat, running water, and for many a viable place to seek shelter, the concepts of a healthy lifestyle and preventive medicine were quickly forgotten – instead, people had to prioritize survival.
This included measures to prevent Covid-19. Many Texas communities have opened heat centers for people without heat. Even with social distancing measures, temperature checks, and compliance with masks, real social isolation was not possible. Experts fear this could lead to a surge in coronavirus cases in the coming weeks. In a congruent aspect of the fight against the pandemic, weather challenges have also significantly hampered vaccination efforts in the state. Deadlines for deliveries have been postponed, vaccination appointments have been canceled as health centers have closed due to the freezing weather, and ultimately, strict parameters for vaccine storage and expiry are likely not to have been met due to the situation at hand.
HOUSTON, TEXAS – FEBRUARY 20: Pallets of water sit by the roadside during a water … [+]
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That is where the meaning of SDOH lies. Millions of Americans face these challenges regularly every day – including lack of access to food, running water, living wages, and decent housing, to name a few. Studies continue to show repeatedly that tackling SDOH is one of the most important factors in managing America’s growing health crisis. As the American Academy of Family Physicians explains: “[SDOH] have a greater impact on population health than factors such as biology, behavior, and health care. SDoH, especially poverty, structural racism and discrimination, are the main causes of health inequalities. Reducing health inequalities is important as they are ubiquitous. unfair and unjust; Affected individuals have little control over the circumstances that contribute to it. affect all; and can be avoided with existing policy solutions. “
The logic behind this is intuitive: if patients struggle to make ends meet at home, how can they prioritize their own health? If a patient has to choose whether to fill out a prescription for blood pressure medication or put groceries on the table, how can they be expected to prioritize the former? How can patients who cannot afford to miss a work day and also have no access to childcare be expected to make routine and frequent visits to their GP? Similar to Affected Americans this week, prioritizing needs is vital, and sustainable healthcare outcomes can only be achieved if certain quality of life parameters are met.
It is for this reason that the conversation about SDOH is becoming increasingly common in the medical community. Industry leaders, government agencies and epidemiological experts are increasingly recognizing the value of investing in communities from the ground up to achieve balanced health care and improve patient care. One can only hope that this conversation will continue to flourish in the years to come to ultimately achieve better long-term outcomes in healthcare.
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