From the Guidelines
The top 5 social determinants of health (SDOH) affecting patient care are economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context, as identified in the most recent study 1. These SDOH have a significant impact on patient outcomes, including morbidity, mortality, and quality of life.
- Economic stability impacts care through factors like employment, income, expenses, debt, and housing security, directly affecting patients' ability to afford medications, transportation to appointments, and healthy food.
- Education access influences health literacy, understanding of treatment plans, and ability to navigate complex healthcare systems.
- Healthcare access encompasses insurance coverage, provider availability, and quality of care received, with uninsured or underinsured individuals often delaying necessary treatment.
- Neighborhood factors include physical environment, transportation options, safety, and food access, with residents of disadvantaged areas facing greater exposure to environmental hazards and limited access to nutritious food.
- Social and community context involves social integration, support systems, community engagement, and experiences of discrimination, with strong social connections associated with better health outcomes and treatment adherence.
Healthcare providers should routinely screen for these factors and connect patients with appropriate resources like food assistance programs, housing support, transportation services, and community health workers to address these barriers to care, as recommended in the latest guidelines 1. The World Health Organization (WHO) defines SDOH as “the circumstances in which people are born, grow up, live, work, and age…and the systems put in place to offer health care and services to a community” 2. Upstream and downstream SDOH both play a crucial role in shaping patient outcomes, with upstream determinants influencing behaviors, disease, and health outcomes, and downstream determinants affecting the clinical setting and healthcare delivery system 2. By addressing these SDOH, healthcare providers can improve patient outcomes, reduce health inequities, and promote better health and well-being, as emphasized in recent studies 3, 1, 4.
From the Research
Social Determinants of Health Affecting Patient Care
The top 5 Social Determinants of Health (SDOH) affecting patient care are:
- Access to healthcare 5, 6
- Economic stability, including food security and financial resources 7, 5, 6
- Built environment, including housing issues and exposure to violence/crime 5, 6
- Educational environment, including language and health literacy 5, 6
- Social context, including social identity and socioeconomic disparities 5, 8, 6
Key Findings
- Studies have shown that SDOH, such as insecure access to food, housing, and financial resources, are critical threats to overall health 7
- Primary care providers have a promising, yet underused, opportunity to intervene in SDOH 7, 5
- Emergency departments have implemented various interventions to address SDOH, including provider educational interventions, disease modification with SDOH focus, and direct SDoH interventions 6
- A conceptual framework, such as the OASIS framework, can help guide healthcare systems in addressing unmet social needs and improving health outcomes 9