Addressing Social Determinants of Health and Health Disparities: A Vital Direction for Health and Health Care

Abstract

This publication is part of the National Academy of Medicine's Vital Directions for Health and Health Care Initiative, which called on more than 150 leading researchers, scientists, and policy makers from across the United States to assess and provide expert guidance on 19 priority issues for U.S. health policy. The views presented in this publication and others in the series are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors' organizations. Learn more: nam.edu/VitalDirections.

“You only have time for so much in 12 hours” unmet social needs of hospitalised patients: A qualitative study of acute care nurses

“…At the beginning of each focus group, nurses completed a demographic questionnaire to elicit information including name, age, zip code, gender, years of experience, nursing unit and education level. An interview guide with 10 questions and probes was utilized during each focus group and was developed from the literature and research of care of socially at‐risk patients (Table for Interview Guide; Adler et al, ; Braveman & Gottlieb, ). Focus groups were held in private conference rooms in the hospital; recorded using digital audio recording devices; and lasted approximately 1 hr.…”

“…Prior to the start of each focus group, participants were asked to select a pseudonym which was used throughout the interview to protect confidentiality. Each focus group began with the facilitator providing a brief definition of “social risk” based upon previous research (Adler et al, ). Nurses were then asked, “How do you recognise a patient who has high social needs?” Next, nurses shared personal experiences about caring for this patient population (e.g., “On a recent shift, have you provided care for someone who was socially at‐risk?”).…”

Patient-Centered Communication

“…Typically, health care services and genetics only account for 10-20% of a person's health, whereas the largest contribution comes from the Social Determinants of Health as well as individual health behavior [9,10]. Therefore, rather than investing more dollars into healthcare services, factors that play a greater role in health are deserving of attention [11,12]. Determinants of Health [7] clinical health care services genetic vulnerability socio-economic characteristics physical environment individual health behavior Fortunately, modern medicine is moving away from a purely biomedical model of care with an emphasis on disease and its associated biological components (signs, symptoms, and laboratory tests) to a biopsychosocial model.…”

“…Typically, health care services and genetics only account for 10-20% of a person's health, whereas the largest contribution comes from the Social Determinants of Health as well as individual health behavior [9,10]. Therefore, rather than investing more dollars into healthcare services, factors that play a greater role in health are deserving of attention [11,12]. Table 1.…”

Why caesarean is more unequally concentrated among better-off people in Tehran? A concentration index decomposition approach

“…In the past two decades, issues related to social determinants of health have earned a special place in the public health domain 12. The concept of social determinants of health implicitly indicates the existence of social and economic inequalities in the distribution of health in human societies 13. WHO declared that social factors are responsible for 55% of the causes of diseases and health problems and introduced the factors as the cause of all causes of diseases 14.…”