Social determinants of health (SDOH) are pivotal factors impacting individuals’ well-being. Housing security, transportation, and food security are key SDOH, but they encompass a complex web of interrelated issues. Healthcare organizations increasingly focus on these determinants due to tangible solutions. However, SDOH extend beyond these areas to include race, ethnicity, gender identity, environment, educational attainment, and adverse childhood experiences. These factors profoundly affect health outcomes, emphasizing the need for comprehensive, patient-centered care. Understanding and addressing SDOH is essential in building a holistic approach to healthcare that promotes well-being for all individuals.
In the realm of healthcare, social determinants of health (SDOH) have emerged as pivotal considerations. Healthcare professionals must delve into various determinants, from food security to adverse childhood experiences, to comprehensively grasp this concept. These determinants encompass the conditions in which people are born, grow, work, live, and age, and they encompass non-medical factors that significantly impact an individual’s health.
SDOH are a complex web of social factors, often interrelated. For instance, unemployment can lead to food or housing insecurity, setting off a cascade of health-related issues. Recognizing this, healthcare organizations have started giving more attention to SDOH, with a focus on housing security, transportation, and food security due to their tangible solutions.
However, SDOH encompass more than these three factors and can intertwine. Issues like race and racism present macro challenges requiring cultural change, which may be beyond the control of healthcare organizations. Despite this, healthcare organizations must comprehend the entire scope of SDOH to build comprehensive, patient-centered care.
Housing Security:
Housing security goes beyond mere shelter; it encompasses challenges like difficulty paying rent, overcrowding, frequent moves, and high housing costs. These issues can leave individuals with little resources for necessities like food, healthcare, and transportation, all crucial SDOH.
Homelessness is a grave concern under housing security, leading to chronic illness and barriers to accessing healthcare. Frequent moves can disrupt healthcare relationships and access.
The quality of housing is also vital for health; homes without utilities or ridden with vermin are detrimental.
Transportation:
Transportation is a critical SDOH as it affects access to social services and healthcare. Factors like lack of vehicle access, inadequate infrastructure, high transportation costs, adverse policies, and lengthy travel times can combine to hinder access to essential services, resulting in poor health outcomes.
Transportation issues affect other SDOH, such as accessing grocery stores or social services addressing different determinants.
Food Security:
Food security is essential for overall health, particularly for those with diet-related illnesses like diabetes or heart disease. It includes issues like limited access to quality food, compromising food quality, and changing eating patterns due to budget constraints.
Some live in food deserts, while others in food swamps with limited access to nutritious options, both impacting food security.
Income & Employment Conditions:
Low income can lead to food insecurity and affect overall health. Employment opportunities are central to economic stability, but many face barriers to finding and keeping jobs. Even steady, well-paying jobs can come with adverse working conditions affecting health.
Race, Ethnicity & Preferred Language:
Race, ethnicity, and language preference are significant SDOH. Disparities in health outcomes have been linked to these factors, likely due to implicit bias and structural racism. Everyday experiences of racism can also negatively impact health.
These factors can also influence other SDOH, contributing to health disparities.
Gender Identity & Sexual Orientation:
Gender identity and sexual orientation can shape health outcomes. LGBTQ+ individuals often face difficulty finding healthcare providers who deliver compassionate care without discrimination, leading to disparities in health and mental healthcare access.
Environment & Neighborhood:
Neighborhood characteristics influence public safety, access to green space, and overall well-being. Built and non-built environment factors like air and water quality, climate change, and extreme weather events directly impact health.
Educational Attainment:
Educational attainment is linked to longevity and health literacy, influencing SDOH such as employment, healthcare access, and patient experience.
Adverse Childhood Experiences (ACEs):
ACEs, potentially traumatic childhood events, can have a lasting impact on mental and physical health. Childhood adversity, especially related to racism and socioeconomic burdens, can lead to changes in brain structure and increased risk for mental health conditions.
Overall, understanding and addressing these social determinants of health comprehensively is crucial for building a holistic and patient-centered approach to healthcare.
