Social Determinants of Health 101 for Health Care: Five Plus Five

Magnan, Sally Sieloff

doi:10.31478/201710c

Cited by 195 publications

(151 citation statements)

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“…By studying parents of AYAs 18-33 years, a broader age than is commonly utilized in HCT studies, we were able to identify concerning gaps in HCT services and other supports within and across systems for the ID population. Based on estimates that medical care explains only 10-20% of a populations modifiable contributors to healthy outcomes (Hood, Gennuso, Swain, & Catlin, 2016;Magnan, 2017), it is critical to seek ways systems can collaborate to optimize health for the ID population.…”

Section: Discussionmentioning

confidence: 99%

Health Care Transition for Adolescent and Young Adults with Intellectual Disability: Views from the Parents

Franklin

Beyer

Brotkin

et al. 2019

Journal of Pediatric Nursing

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This study explored the health care transition (HCT) experiences of parents of adolescents and young adults (AYAs) with intellectual disability (ID), 18-33 years of age, including barriers and facilitators to the AYA's transition to adulthood within and between the medical, educational, community, and vocational systems. Design and methods: A qualitative descriptive design with semi-structured individual interviews with 16 parent participants was used. Purposive sampling of parents was utilized with variation on race/ethnicity and AYA age, stage in transition, and condition. This study was conducted through a major medical center in the southeast United States. Content analysis was utilized. Results: Three overarching themes represented the factors and essence of supporting AYAs with ID transition to adulthood. Inefficient and siloed systems illuminated barriers families are commonly experiencing within and between the medical, educational, community, and vocational systems. 'Left out here floundering' in adulthood, described the continued inadequacy of resources within each of these systems and parent's having to find available resources themselves. Hope despite uncertainty, included the perceived costs and benefits of their AYA's disability and the value of parent peer support in providing key knowledge of resources, strategies, and perspectives. Conclusions: Our findings illuminate the need for improved infrastructure to provide effective HCT and partnerships to help integrate HCT support within other life course systems. Results support the rationale for noncategorical HCT-focused approach. Practice implications: A parent peer coach-facilitated intervention offers promise for bridging the gap between systems and meeting family needs.

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Section: Discussionmentioning

confidence: 99%

Health Care Transition for Adolescent and Young Adults with Intellectual Disability: Views from the Parents

Franklin

Beyer

Brotkin

et al. 2019

Journal of Pediatric Nursing

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“…It is not discernable from the data as to why a lower rate of caries‐related treatment was observed for female (26 percent), Asian and Black/African American (19 percent), and Hispanic (27 percent) Veterans. Given the complexities of the social determinants of health and findings from previous VA studies demonstrating racial and ethnic disparities , future work should examine whether the variation observed represents actual differences in need or differences in treatment provided.…”

Section: Discussionmentioning

confidence: 99%

Caries prevalence and associations with medications and medical comorbidities

Jurasic

Gibson

Wehler

et al. 2018

J Public Health Dent

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Objectives To use extensive electronic dental, medical, and pharmacy databases to estimate the prevalence of dental caries in a cohort of new patients during a 5‐year period (FY2010–FY2015) and determine whether medication use and medical comorbidities are associated with caries prevalence. Methods This was a retrospective analysis of existing data from the Department of Veterans Affairs (VA). The number of teeth treated due to a caries‐related diagnosis was determined and outcomes were presented as number of teeth/person and proportion of patients receiving caries‐related treatment. Logistic and negative binomial regression modeled teeth/person with caries‐related treatment; covariates included age, gender, race, ethnicity, physical and mental comorbidities, and use of prescription medications and prescription drugs with strong anticholinergic properties. Results The study population included 95,850 dentate dental patients: 92.1 percent were male, mean age of 58.7 ± 12.6 years, 73.2 percent were White/Caucasian, and 21.3 percent were Black/African American. They were taking a mean of 10.6 ± 5.9 VA prescription drug classes, 0.6 ± 0.4 drugs with strong anticholinergic properties, and had 3.6 ± 2.2 physical and 1.4 ± 1.2 mental comorbidities. On average, 2.2 teeth/person received caries‐related treatment and 58 percent of the study population received any caries‐related treatment. An increase in the rate of caries‐related treatment in Veterans was statistically significantly associated with increased prescription medication use; one or more drugs with strong anticholinergic properties and with 1+ mental comorbidities. Increased physical comorbidity was not statistically significantly associated with caries‐related treatment. Conclusions This study demonstrates a high prevalence of caries among Veteran dental patients, with an increased prevalence in those taking higher numbers of prescription medications.

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“…Leveraging SDOH requires access to various types of data (e.g., clinical, demographic, geographical, educational, socioeconomic, etc.) (Magnan, 2017) in order to run predictive analytics and guide programs and policy for the most vulnerable groups. In 2017, the Centers for Disease Control and Prevention initiated a set of proof of concepts around public health surveillance using blockchain technology with the intent to build real applications in 2018.…”

Section: The Blockchain Opportunitymentioning

confidence: 99%

Incentivizing Change Within Social Determinants of Health Using Blockchain Technology

McFarlane

Finch²,

Gray

et al. 2020

Front. Blockchain

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There are growing initiatives and calls to focus greater attention to the social determinants of health (SDOH) and their impact on population health (Heiman and Artiga, 2015). Several emerging strategies are being used to begin to address social determinants, such as the use of health impact assessments and applying health in all policies (HiAP). These strategies and tools are being implemented in an effort to review existing and needed policies, as well as to propose new policies to lessen health disparities (Koh et al., 2011). Efforts to further integrate SDOH through the use of health information technology and other emerging technologies, such as distributed ledger technology both in and outside of existing healthcare systems, are also increasing (Koh et al., 2011). Understanding and addressing the SDOH through both traditional and non-traditional sectors is key to further reducing health disparities (Heiman and Artiga, 2015; Cottrell et al., 2018; McGinnis et al., 2002). Through exploration of the current state of SDOH in the healthcare industry, an analysis of blockchain technology will render the acceleration and adoption of SDOH to effectively provide improved health outcomes.

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Social Determinants of Health 101 for Health Care: Five Plus Five

Cited by 195 publications

References 0 publications

Health Care Transition for Adolescent and Young Adults with Intellectual Disability: Views from the Parents

Health Care Transition for Adolescent and Young Adults with Intellectual Disability: Views from the Parents

Caries prevalence and associations with medications and medical comorbidities

Incentivizing Change Within Social Determinants of Health Using Blockchain Technology

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