The term Social Determinants of Health (SDOH) refers to the social, economic, environmental, and demographic factors that influence health outcomes. These are “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.”1 These are also the non-medical factors that could impact a person’s overall health.
SDOH Factors contribute to about 40% of variation in health status among individuals2. Despite the impact of SDOH on a patient’s health outcomes and costs, providers and payers are not equipped to address the several social determinants including housing, education, food security, and economic stability.
UNDERSTANDING THE PROBLEM
It is important to understand the factors, other than medical, affecting the life of an individual.
Factors like housing, food security, access to care, etc., are concerns that may affect the health of the population. An approach of SDOH-led quality initiatives lies beyond the four walls of the clinical setting. Data gathering, with screening tools, focus groups, community congregation, etc., is required to gain an understanding of key social factors that impact population health. In the process of data collection, consider factors that are vital to population health, significant for the care giver/provider and health insurers, since these factors might not be related and may belong to different datasets all together.
THINKING BEYOND THE WALLS
New interventions need to be developed for quality improvement activities to tackle issues attributable to SDOH. Also, an intervention that works with one population set may not work for another. Minimal or no attention to SDOH factors can lead to failure of understanding of the problem for the given population set. Quality improvement programs that directly address SDOH will need to engage representatives from housing, transportation, education, public safety, school, social care, and beyond. Due to the varied spectrum of stakeholders, it might create new challenges for implementation because of separate priorities, funding streams, etc. Nevertheless, it is the only way to address interlocking influences on health. It is to be noted that this approach does not undermine the inclusion and efforts of nurses, caregivers, providers, administrators, etc., in quality improvement activities.
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