by Julia Estampa
The US healthcare system spends large sums of money on healthcare in comparison to other developed countries while ranking very low on positive health outcomes and/or average life expectancy. Studies reveal that this can possibly be attributed to the United States’ heavy focus on medicalized interventions in dealing with healthcare, instead of putting more emphasis on fixing pervasive issues, such as addressing social determinants of health (SDOH) that accounts for about 80-90% of the contributing factors that affect one’s health. More importantly, this SDOH severely affects marginalized groups the most. In an attempt to better one’s quality of life and break health inequity, it is of great importance to first address the root causes of these social vulnerabilities that give rise to poor quality of health: social determinants of health.
Social determinants of health or SDOH are nonmedical factors that influence one’s
health. The World Health Organization (WHO) describes SDOH as “the conditions in which
people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life.” In other words, this encompasses factors such as access to healthcare, education, socioeconomic status, race, gender, and discrimination. For instance, a patient’s income can influence their access to nutritious foods, housing stability, and overall access to medical care due to its unattainable high cost. For example, while others would love to eat healthily, personal choice is highly limited due to socioeconomic factors or social or environmental conditions where different people overall do not share the same food accessibility or opportunities to consume food that are optimal for their health. This is concerning because this limitation to healthy food choices can make them more susceptible to health complications. Furthermore, as reported by the American Medical Association (AMA), the costs of healthcare are rising by approximately 4.5% per year, in which the average cost of health insurance in 2020 was $456 for an individual and $1,152 for a family every month. While these statistics may differ depending on one’s personal needs, the general trend where the cost of healthcare increases yearly remains the same. In fact, a 2019 survey by the Physicians Advocacy Institute (PAI) revealed that 80% of physicians believe that their patients often or sometimes refuse or delay care due to cost concerns. This is a serious issue because if patients’ access to healthcare is
limited due to cost, then this may greatly impact their quality of life or their capacity to receive optimal health. Thus, it is important to consider that policies should be enacted to help mitigate these concerns.
Additionally, race and ethnicity are risk markers for underlying health conditions. For
example, in 2018, 9.7% of Black Americans did not have health insurance, while among white Americans, this rate was 5.4%. Another prevalent example that has greatly illuminated the health
disparities that many marginalized groups have been grappling with is the spread of COVID-19. According to the Centers for Disease Control and Prevention (CDC), American Indian and Alaska Native (AIAN), Asian, Black, and Hispanic People have a higher risk of COVID-19 infection, hospitalization, and death than their white counterparts. As of November 30, 2020, studies have shown that Hispanic, Black, and AIAN people were almost three times as likely to die from COVID-19 and about four times as likely to be hospitalized as White people. In New York, rates of hospitalizations and deaths were highest in the Bronx, the district with the highest proportion of racial or ethnic marginalized groups living in poverty where access to healthcare is limited. This demonstrates that social determinants of health, such as race and ethnicity, are strongly linked to one’s health, and it signifies how crucial it is to address SDOH to promote the overall quality of people’s lives. Achieving health equity, by minimizing SDOH, should be perceived as the new kind of “Herd Immunity.” Comparable to how many consider vaccines as a necessity to improve the overall health in populations, addressing social determinants of health should also be reevaluated and heavily considered as a critical step towards eliminating health inequities.
Health equity is when every individual has the opportunity to live in their optimal quality
of health. However, social determinants of health may act as a barrier that limits one’s capability of achieving quality healthcare. Aside from potentially making necessary changes that ensure policies directed at promoting health equity are effectively working, a few possible suggestions that can help attenuate health inequity include recognizing how social determinants of health affect marginalized groups; providing education, treatment, and access to health resources to more impacted communities; and catering feasible or low-cost services for low-income populations.
Overall, understanding social determinants of health allow us to obtain a holistic picture of patients’ or people’s overall health and well-being. Being more informed about the effects of SDOH in communities enables us to better address the systemic issues of health disparities that severely impact many marginalized groups. Ultimately, aside from looking at patients with a clinical eye, we can build better healthcare by breaking social determinants of health, that is, through perceiving people more holistically by incorporating one’s understanding of social
determinants of health to provide a more personalized method of improving people’s health.
Bibliography
“Covid-19 Cases and Deaths by Race/Ethnicity: Current Data and Changes over Time.” KFF, 22 February 2022,
https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-cases-and-deaths-by-race-
ethnicity-current-data-and-changes-over-time/#:~:text=These%20age%2Dstandardized%
20data%20show,19%20infection%20than%20White%20people.
“Health Equity: Definition, Examples, and Action.” Medical News Today, MediLexicon
International,
Karmakar M, Lantz PM, Tipirneni R. Association of Social and Demographic Factors With
COVID-19 Incidence and Death Rates in the US. JAMA Netw Open.
2021;4(1):e2036462. doi:10.1001/jamanetworkopen.2020.36462
“Pai-NORC Survey Shows High Deductible Health Plans Are a Barrier to Needed Care.”
Physicians Advocacy Institute,
http://www.physiciansadvocacyinstitute.org/Advocacy/Health-Plan-Advocacy/High-Ded
uctible-Health-Plans.
Probasco, Jim. “Why Do Healthcare Costs Keep Rising?” Investopedia, Investopedia, 9 Mar.
2022, https://www.investopedia.com/insurance/why-do-healthcare-costs-keep-rising/.
“Risk for COVID-19 Infection, Hospitalization, and Death by Race/Ethnicity.” Centers for
Disease Control and Prevention, Centers for Disease Control and Prevention,
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospital
ization-death-by-race-ethnicity.html.
“Social Determinants of Health.” World Health Organization, World Health Organization,
Taylor, — Jamila, et al. “Racism, Inequality, and Health Care for African Americans.” The
Century Foundation, 1 Nov. 2021,
https://tcf.org/content/report/racism-inequality-health-care-african-americans/#:~:text=are
%20African%2DAmerican.-,Yet%2C%20this%20population%20is%20still%20more%2
0likely%20to%20be%20uninsured,just%205.4%20percent%20among%20whites.
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