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Social Determinants of Health

What are Social Determinants of Health, and why are they important to home healthcare clinicians? Social Determinants of Health are defined as: “…the conditions in the environment 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” (Healthy People 2030, nd). These factors can have a profound affect on health - a newborn infant discharged to an older home with lead paint, a school age child with asthma playing and attending school in a neighborhood with poor air quality, an older adult with diabetes and hypertension living in a neighborhood where small corner stores and fast-food establishments abound. In fact, it is estimated that up to 80% of an individual’s health is determined by social and economic factors. 

Healthy People 2030 lists five areas of social determinants of health:
  • Economic stability​
  • Healthcare access and quality
  • Education access and quality
  • Neighborhood and built environment
  • Social and community context
Beginning this month, Social Determinants of Health items will be added to sections A, B, and D of the Outcomes and Assessment Information Set, more commonly known as OASIS-E. (Corridor, nd). The Social Determinants of Health categories to be collected include ethnicity, race, language, transportation, health literacy, and social isolation. This is a first step in recognizing and addressing the many “upstream” factors that result in disease, disability, and reduced quality of life. The healthcare system as we know it won’t change overnight, but we can’t continue to treat the symptoms of social determinants of health – it’s time to address the core issues. 

If you are unfamiliar with social determinant of health, I urge you to watch Dr. Rishi Manchanda’s popular 2014 Ted Talk.

References


Healthy People 2030. (nd). Social determinants of health​.

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