From the Guidelines
Social determinants of health (SDOH) must be addressed to improve health outcomes, and this can be achieved by assessing and referring patients to local community resources, providing additional self-management support, and considering the involvement of community health workers, as recommended by the most recent guidelines 1. To address SDOH, it is essential to understand that they include economic stability, education access, healthcare access, neighborhood environment, and social context, all of which significantly impact health outcomes.
- Economic factors like income and employment directly affect one's ability to afford healthcare and maintain healthy living conditions.
- Educational attainment correlates with better health literacy and preventive care utilization.
- Physical environment factors such as housing quality, transportation options, and neighborhood safety influence health behaviors and outcomes.
- Social support networks provide emotional resources that buffer against stress and promote well-being. According to the latest guidelines 1, assessing food insecurity, housing insecurity/homelessness, financial barriers, and social capital/social community support is crucial to inform treatment decisions, with referral to appropriate local community resources.
- Providing patients with additional self-management support from lay health coaches, navigators, or community health workers when available can also improve health outcomes.
- Considering the involvement of community health workers to support the management of diabetes and cardiovascular risk factors, especially in underserved communities and health care systems, is also recommended 1. The American Diabetes Association recognizes the association between social and environmental factors and the prevention and treatment of diabetes, and has issued a call for research to better understand how social determinants influence behaviors and how the relationships between these variables might be modified for the prevention and management of diabetes 1. Therefore, addressing SDOH requires coordinated efforts across multiple sectors, including healthcare, education, housing, and transportation, with particular attention to vulnerable populations who experience the greatest health disparities, and should be based on the most recent and highest quality evidence available 1.
From the Research
Definition of Social Determinants of Health (SDOH)
- Social determinants of health (SDOH) are the conditions in which people live and work that shape access to essential social and economic resources 2.
- These determinants can have a significant impact on health outcomes and are often shaped by factors such as socioeconomic status, geography, and culture.
Addressing SDOH to Improve Health Outcomes
- Addressing SDOH requires a multileveled intervention design that incorporates evidence-based strategies and community-engaged research 3.
- Interventions can be implemented within the healthcare system, as well as in upstream factors such as housing, neighborhood conditions, and socioeconomic status 4.
- A well-designed population health management strategy that addresses SDOH can yield improved outcomes for a given community, while improving the financial health of healthcare systems and providers 5.
Frameworks for Addressing SDOH
- The OASIS (Outcomes from Addressing SDoH in Systems) conceptual framework provides a unifying approach to understanding the mechanisms by which healthcare-based unmet social need interventions can improve health outcomes 2.
- Policy implementation science can also play a critical role in addressing SDOH, by evaluating the impact of policies on health equity outcomes and examining differential effects of varied policy implementation processes across population groups 6.
Key Strategies for Addressing SDOH
- Aligned care delivery, community engagement, education, and technology are key strategies required to address the needs of patients and communities 5.
- Systematic evaluation of social and economic policies that might have health consequences is also necessary to improve the underlying conditions that impact the health of populations 4.
- Development of an explicit policy implementation science agenda focused on health equity can help to bridge scientific evidence and policy adoption and implementation 6.