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social determinants of health

- social determinants of health is defined by the World Health Organization as the conditions in which people are born, grow, work, live, & age encompassing the forces & systems shaping conditions of daily life [5] - Centers for Medicare & Medicaid Services & state Medicaid agencies have incorporated social needs as an element of care innovation [5] Etiology: Includes: - how people live - access to health care - health insurance - problems affording medications - economic stability (income, financial resources) - housing, home environment, neighborhood - living with a partner, marriage - domestic safety, domestic abuse - transportation - food insecurity - climate & environmental exposures - education* (educational environment) - recreation & socialization (social isolation, social support) - unemployment, work (occupational environment) - race, gender [6] - psychosocial stress Clinical significance: - Life expectancy due to social determinants of health (points) [6] Category points female +4 never married -5 previously married -3 high school education only -5 college degree +2 white +1 hispanic +2 * education, race, gender & marriage account for 18 years of life-expectancy [6] - it might be argued that race & gender (sex) are more genetic than social Management: - consider depression when addressing social determinants of health - less education, being unmarried, unemployment, lack of health insurance are associated with higher PHQ-9 scores [3]

Interactions

disease interactions

Related

screening for social determinants of health (PRAPARE)

General

determinants of health

References

  1. He J et al. Social, behavioral, and metabolic risk factors and racial disparities in cardiovascular disease mortality in U.S. adults: An observational study. Ann Intern Med 2023 Aug 15; [e-pub] PMID: 37579311 https://www.acpjournals.org/doi/10.7326/M23-0507
  2. Buitron de la Vega P, Losi S, Sprague Martinez L et al Implementing an EHR-based Screening and Referral System to Address Social Determinants of Health in Primary Care. Med Care. 2019 Jun;57 Suppl 6 Suppl 2:S133-S139. PMID: 31095052
  3. Califf RM, Wong C, Doraiswamy PM Importance of Social Determinants in Screening for Depression. J Gen Intern Med. 2022 Aug;37(11):2736-2743. PMID: 34405346 PMCID: PMC9411454 Free PMC article.
  4. Morelli V Social Determinants of Health: An Overview for the Primary Care Provider. Prim Care. 2023 Dec;50(4):507-525. PMID: 37866828 Review.
  5. Drake C, Batchelder H, Lian T et al Implementation of social needs screening in primary care: a qualitative study using the health equity implementation framework. BMC Health Serv Res. 2021 Sep 17;21(1):975. PMID: 34530826 PMCID: PMC8445654 Free PMC article.
  6. Bergeron-Boucher MP, Callaway J, Strozza C, Oeppen J. Inequalities in lifespan and mortality risk in the US, 2015-2019: a cross-sectional analysis of subpopulations by social determinants of health. BMJ Open. 2024 Aug 5;14(6):e079534. PMID: 39106997 Free article. https://bmjopen.bmj.com/content/14/6/e079534
  7. Hudgins V Social Determinants of Health: The Physician's Role. MedPage Today. July 29, 2024 https://www.healthecareers.com/medpage/career-resources/on-the-job/social-determinants-of-health-the-physicians-role