- To address the care disparities associated with the social determinants of health, healthcare stakeholders must adjust data collection, medical education, and public policy, the American College of Physicians (ACP) has argued.
Despite being one of the 10 richest countries in the world per capita, the United States experiences sizable health disparities that are rooted in social, economic, and environmental factors.
In a recent article published in Annals of Internal Medicine, ACP noted that place of birth in the US is more strongly associated with life expectancy than race or genetics, demonstrating on average a 15-year difference in life expectancy between the most advantaged and disadvantaged citizens.
To improve outcomes for all patients, healthcare stakeholders should develop an understanding of the social determinants of health, and the major role these factors play in overall wellness.
“A greater focus on social determinants of health can enable physicians to become stronger advocates for patients and to help reduce negative health outcomes that are often associated with social determinants of health,” said ACP President Jack Ende, MD, MACP, in a public statement.
ACP stated that this will require increased screening and collection of social determinants of health data, which will aid health impact assessments and further support evidence-driven decision making.
However, social determinants data is often more difficult to obtain than clinical data, as socioeconomic information is usually not collected within an electronic health record (EHR).
When included, this information is typically in an unstructured format, hidden in free-text clinical notes. Physicians often feel as though they lack the time and resources to assess their patients’ social determinants data.
In acknowledgment of this issue, ACP recommended that stakeholders develop best practices for utilizing EHR data to improve individual and population health without adding to the administrative burden on physicians.
ACP also advised that the underlying individual, community, and systemic issues that lead to care disparities be incorporated into medical education at all levels, including training and practice. This will ensure that providers have the knowledge required to treat patients whose health is affected by social determinants.
Research will also play an integral role in promoting awareness of social determinants. ACP expressed their support for research efforts that will investigate the causes and effects of the social determinants of health. These studies should recruit participants from underserved populations to better understand how social determinants impact wellness.
ACP noted that policymakers will be a strong force in facilitating these changes.
The organization called for policymakers to encourage health in all policies and use health impact assessments to integrate health considerations into community planning decisions.
ACP also recommended that policymakers implement public strategies that will address downstream environmental, geographical, and educational social determinants to encourage health equity. In addition, the College will support the funding of social services and programs that have been shown to reduce health disparities and care costs.
These efforts will help providers and other healthcare stakeholders recognize and confront non-medical issues that contribute to overall wellness.
“Taking a closer look at social determinants of health can help us better understand and address the social factors that have an impact on patient health,” Ende said.
“It’s important that physicians and other medical professionals recognize and account for social determinants of health to create a more comprehensive approach with our patients.”
By employing a method that incorporates social determinants of health, healthcare professionals can not only reduce health disparities, but eradicate them entirely.
“Such an approach can help to eliminate significant health inequalities often associated with social determinants of health, such as homelessness, food insecurity, and mental health stressors such as domestic violence or social isolation,” Ende concluded.