Social determinants shape factors such as health, functionality, and quality of life. The healthcare industry is starting to change the way they address social determinants with patients, recognizing the impact they have on patient outcomes and treatment. County Health Rankings noted that social determinants, including health behaviors, physical environment, and social/economic factors, account for 80 percent of health outcomes.
The COVID-19 pandemic has been a reminder to healthcare officials that social determinants of health (SDOH) can lead to disaster if not addressed. Disparities in treatment and care access have contributed to the deaths of thousands. The data to help build a better picture of a patient’s SDOH is out there, but much of it is siloed across multiple organizations, each with its own standards for data collection and exchange.
Much of this data is unstructured and difficult to use effectively. This includes data in forms such as notes on paper, recordings, and surveys that don’t make it into most EHRs. In addition, data privacy is still a major concern, with some data held by organizations not subject to HIPAA regulations. It has been a challenge for most healthcare organizations to develop mechanisms by which patients can give consent to share data, though there are often missing links in this process.
Even without data, many of the challenges facing health outcomes are apparent. The upsurge of telehealth during the pandemic has been a necessary change, but even then, the challenge of obtaining or using technology creates barriers of its own. Outside of a clinical setting, difficulties in working conditions, child care, or transportation (among many others) contributed to worse health and potential exposure to the virus.
All of this speaks to a need to construct treatment around the context of patient lives. Much of healthcare is reactive, dealing with problems as they arise instead of acknowledging how preventative care can lead to better outcomes over time. This is not a perfect approach, as without a robust methodology for collecting data, patient self-reporting has to compensate.
The gradual digitization of data, accelerated during the pandemic, provides the foundation to better account for SDOH. As health records become more comprehensive, clinicians can construct longitudinal models of patient lives and gain a better understanding of the overall impact of SDOH. Better digital protections for privacy in data exchange or otherwise will also be necessary. This includes identity verification for patients, documented consent, and the use of decentralization.
Even before this happens, clinicians have the power to incorporate SDOH into their practices. Screening patients about SDOH can allow clinicians to build a holistic treatment plan based on these factors and construct better models for long-term health. No two patients are exactly alike in their SDOH, and healthcare organizations should always be striving to recognize the ways they can adapt to this.