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“Social Determinants of Health and Chronic Disease Outcomes – Part 3

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Introduction

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Social Determinants of Health and Chronic Disease Outcomes – Part 3

Chronic diseases, such as heart disease, stroke, cancer, type 2 diabetes, and obesity, are among the leading causes of death and disability in the United States. According to the Centers for Disease Control and Prevention (CDC), six in ten adults in the U.S. have a chronic disease, and four in ten adults have two or more. Chronic diseases are also a major driver of healthcare costs in the U.S., accounting for 90% of the nation’s $3.8 trillion in annual healthcare expenditures.

While individual behaviors, such as smoking, poor diet, and physical inactivity, play a role in the development of chronic diseases, they are not the only factors. Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDOH can include factors such as socioeconomic status, education, access to healthcare, neighborhood and built environment, and social and community context.

In this blog post, we will explore the relationship between SDOH and chronic disease outcomes. We will also discuss some of the strategies that can be used to address SDOH and improve chronic disease outcomes.

The Relationship Between SDOH and Chronic Disease Outcomes

SDOH can have a significant impact on chronic disease outcomes. For example, people who live in low-income neighborhoods are more likely to be exposed to environmental hazards, such as air pollution and lead paint. They are also less likely to have access to healthy foods and safe places to exercise. As a result, people who live in low-income neighborhoods are at higher risk for developing chronic diseases, such as asthma, heart disease, and diabetes.

Education is another important SDOH. People with higher levels of education are more likely to have jobs that provide them with health insurance and paid sick leave. They are also more likely to have the knowledge and skills they need to make healthy choices. As a result, people with higher levels of education are at lower risk for developing chronic diseases.

Access to healthcare is also a critical SDOH. People who do not have access to healthcare are less likely to receive preventive care, such as screenings and vaccinations. They are also less likely to receive timely treatment for chronic diseases. As a result, people who do not have access to healthcare are more likely to die from chronic diseases.

Social and community context can also impact chronic disease outcomes. People who have strong social support networks are more likely to cope with stress and manage their chronic diseases. They are also more likely to engage in healthy behaviors, such as eating a healthy diet and exercising regularly.

Strategies to Address SDOH and Improve Chronic Disease Outcomes

There are a number of strategies that can be used to address SDOH and improve chronic disease outcomes. These strategies include:

• Improving access to healthcare: This can be done by expanding Medicaid, increasing funding for community health centers, and using telehealth to reach people in rural areas.
• Addressing food insecurity: This can be done by increasing funding for food banks, providing nutrition education, and creating community gardens.
• Improving housing: This can be done by increasing the supply of affordable housing, providing housing vouchers, and enforcing housing codes.
• Improving education: This can be done by increasing funding for schools, providing early childhood education, and offering job training programs.
• Creating safe and healthy communities: This can be done by investing in parks and recreation, improving transportation infrastructure, and reducing crime.
• Addressing racism and discrimination: This can be done by implementing policies that promote equity, providing cultural competency training, and addressing implicit bias.

Examples of Interventions to Address SDOH and Improve Chronic Disease Outcomes

There are many examples of interventions that have been shown to be effective in addressing SDOH and improving chronic disease outcomes. Some examples include:

• The Harlem Children’s Zone: This program provides a comprehensive range of services to children and families in Harlem, New York. The program includes early childhood education, after-school programs, health services, and parent education. Studies have shown that the Harlem Children’s Zone has been successful in improving educational outcomes, reducing poverty, and improving health outcomes for children and families in Harlem.
• The Nurse-Family Partnership: This program provides home visits from nurses to low-income, first-time mothers. The nurses provide education and support on topics such as prenatal care, infant care, and parenting. Studies have shown that the Nurse-Family Partnership has been successful in improving maternal and child health outcomes, reducing child abuse and neglect, and improving the economic self-sufficiency of families.
• The Complete Health Improvement Program (CHIP): This program is a lifestyle intervention that helps people make healthy changes to their diet, exercise habits, and stress levels. Studies have shown that CHIP has been successful in reducing the risk of heart disease, stroke, diabetes, and other chronic diseases.

The Role of Healthcare Providers

Healthcare providers can also play a role in addressing SDOH and improving chronic disease outcomes. Healthcare providers can:

• Screen patients for SDOH: This can be done by asking patients about their housing, food security, transportation, and other social needs.
• Refer patients to resources: Healthcare providers can refer patients to community resources that can help them address their SDOH needs.
• Advocate for policies: Healthcare providers can advocate for policies that address SDOH, such as increasing funding for affordable housing and food banks.
• Integrate SDOH into care plans: Healthcare providers can work with patients to develop care plans that address their SDOH needs. For example, a patient who is food insecure may need help finding food resources or learning how to prepare healthy meals on a budget.

The Importance of Collaboration

Addressing SDOH and improving chronic disease outcomes requires collaboration across sectors. Healthcare providers, public health agencies, community organizations, and policymakers must work together to create a more equitable and healthy society.

Conclusion

SDOH have a significant impact on chronic disease outcomes. By addressing SDOH, we can improve the health and well-being of all Americans. There are a number of strategies that can be used to address SDOH, including improving access to healthcare, addressing food insecurity, improving housing, improving education, creating safe and healthy communities, and addressing racism and discrimination. Healthcare providers, public health agencies, community organizations, and policymakers must work together to create a more equitable and healthy society.

Addressing SDOH is not only the right thing to do, it is also the smart thing to do. By investing in SDOH, we can reduce healthcare costs, improve productivity, and create a more vibrant and prosperous society.

Future Directions

As we continue to learn more about the impact of SDOH on chronic disease outcomes, it is important to continue to invest in research and evaluation. We also need to develop and implement innovative interventions that address SDOH in a comprehensive and sustainable way.

Some specific areas of focus for future research and intervention include:

• Developing and testing new models of care that integrate SDOH: This could include models that incorporate social workers or community health workers into primary care teams, or models that provide integrated housing and healthcare services.
• Using technology to address SDOH: This could include using mobile apps to connect people with resources, or using data analytics to identify and target populations at high risk for chronic diseases.
• Addressing the root causes of SDOH: This could include policies that address poverty, inequality, and discrimination.

By working together, we can create a society where everyone has the opportunity to live a healthy and fulfilling life. This requires a multi-faceted approach that considers the interplay of various SDOH and their impact on specific chronic conditions. Furthermore, tailored interventions that consider the unique needs of different communities are essential for achieving equitable health outcomes.

Ultimately, addressing SDOH and improving chronic disease outcomes is a complex and challenging task, but it is one that is essential for creating a healthier and more equitable society. By working together, we can make a difference in the lives of millions of Americans.