PODCAST: Poverty in Healthcare Explained

By Eric Bricker MD

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SDOH: What Exactly are They, Anyway?

By Staff Reporters

http://www.MARCINKOASSOCIATES.com

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Social Determinants of Health

 According to Arjun Gosain, some SDOH concepts include:

  • Employment insecurity: Measures whether the patient is employed and their current employment or unemployment experience. This includes whether they were harassed on the job or experiencing unequal pay. Employment insecurity can lead to financial stress, mental health problems, and reduced healthcare access. 
  • Psychological circumstances: Measures current events that are affecting the patient’s health. This encompasses a wide range from unwanted pregnancies to exposure to war or violence. Stress, anxiety, and other negative emotions can have a direct effect on a patient’s physical health and contribute to disease development.
  • Housing insecurity: Notes whether a patient has a consistent place to live or is forced to move regularly. Homelessness or housing insecurity can lead to exposure to the elements, mental health challenges, and increased vulnerability to infection.
  • Social adversity: Examines a patient’s social experience including any discrimination or persecution the individual may be facing. Increased social adversity can cause an individual to socially isolate and develop feelings of depression. 
  • Transportation: Observes the patient’s access to transportation including available public transport. Missed appointments can be the direct result of transportation inaccessibility which leads to a decrease in the quality of care. 
  • Food insecurity: Indicates whether a patient has adequate food access and safe drinking water access. Receiving adequate nutrition is essential for maintaining optimal physical health. For example, if a child is food insecure, it can lead to serious developmental issues and chronic disease.
  • Education and literacy: Observes a patient’s ability to read and comprehend hospital paperwork. Note that individuals with higher literacy and education rates typically make more informed health decisions.
  • Occupational risk: Examines how a patient’s current employment affects their overall health. Determines if their job site places them at risk of toxin exposure, physical harm, undue stress, or other hazardous conditions that can contribute to injuries or illnesses.
  • Economic insecurity: Measures a patient’s poverty level to determine if copays, rent, and hospital bills are manageable. A patient living with inadequate finances will face a greater barrier to quality care. CITE: https://www.r2library.com/Resource/Title/082610254
  • Lack of support: Notes whether a patient has reliable support when experiencing difficult circumstances such as the death of a loved one. If a patient has a present support network, they will be able to receive practical, emotional, and physical assistance in times of need. 
  • Upbringing: Takes a patient’s childhood, family, and upbringing into account to assess if a patient is carrying trauma from previous years. Adverse childhood experiences can increase the risk of chronic diseases and mental health issues later in life. 
  • Language: Examines any language or communication concerns, so that a patient can both communicate their issues and understand oral and written treatment. Miscommunications can lead to misdiagnoses and inadequate treatment. 
  • Physician Stress: https://medicalexecutivepost.com/2022/05/20/sdoh-challenges-physician-stress/

What have we missed?

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