Question

• The evidence documenting social inequalities in health
• Define the social gradient in morbidity and mortality, including examples
• The relationship between socioeconomic status and inequalities in health
• Methods of utilizing the social determinants of health to improve population health
• Implications for healthcare policy and specific action plans to reduce health inequalities

Answer 1

Social Gradient Institute of Health Equity. "The social gradient in health is a term used to describe the phenomenon whereby people who are less advantaged in terms of socioeconomic position have worse health and shorter lives than those who are more advantaged.

social environments may be even more important than those of physical environments. The socially isolated have relative risks of mortality ranging between 1.9 to almost 5 times greater than those with better social connections. 35. Patterns of social interaction also affect disease risk.

SOCIOECONOMIC MEASURES

The principal indicators of one's position in contemporary society are income, occupation, and educational attainment. These are closely related more abstract conception of social position in terms of the three dimensions of class (a primarily economic concept), status (associated with occupational prestige), and power (a function of one's ability to mobilize resources on one's behalf).

THE EXTENT OF SOCIOECONOMIC DIFFERENCES IN MORTALITY AND HEALTH STATUS

The income measure used was gross family income, unadjusted for family size or number of earners. The occupational variable was created by imposing an arbitrary cardinal scale on ordinal categories. It is possible that more refined measures of these variables would have performed better.

Prices of Health-Related Goods and Services

Prices are central to economic models. They are a possible source of socioeconomic differences in mortality for two reasons

Social-Psychological Approaches

. For example, risk premiums can induce people into hazardous or stressful occupations.

General, physical and mental health outcomes

Addressing Social Determinants of Health

1. Diabetes and Social Determinants:-

• 1 in 3 adults with prediabetes
• 90 percent Prediabetic adults who don’t know they have it
• 70 percent Prediabetic adults who will develop diabetes
• 30 million American adults and children with diabetes
• $327 billion annual costs of diagnosed diabetics
• $1 of every $7 healthcare spend on diabetes and complications such as amputations, strokes and kidney failure.

2. Social Determinants of Health in Action:-

• one-minute patient survey can reveal important social determinant information.
• healthcare organizations, physicians and care managers successfully use social determinant data to improve population health, Social Determinants of Health: From Insights to Action.

Examples of Social Determinants of Health

• Income level

• Educational opportunities

• Occupation, employment status, and workplace safety

• Gender inequity

• Racial segregation

• Food insecurity and inaccessibility of nutritious food choices

• Access to housing and utility services

• Early childhood experiences and development

• Social support and community inclusivity

• Crime rates and exposure to violent behavior

• Availability of transportation

• Neighborhood conditions and physical environment

• Access to safe drinking water, clean air, and toxin-free environments

• Recreational and leisure opportunities

Healthcare Leaders Addressing the Social Determinants of Health

1. Healthcare leaders have been progressively shifting toward increasing health equity and addressing the paradigm shift towards population health by attending to the social determinants of health.
2. Healthcare leaders are increasingly aware of the data and research which indicates that the social determinants of health have a higher impact on population health than healthcare and that a higher ratio of social service spending versus healthcare spending results in improved population health.
3. Camden Coalition of Healthcare Providers are using data to identify frequent consumers of emergency care and then connect them to a team of primary care providers, nurses, social workers, and behavioral health specialists.

4. Healthy Neighborhoods Healthy Families:-To promote access to affordable housing, they have partnered with Healthy Homes to revitalize local communities through renovation, energy efficiency and green living projects, and repair and maintenance grants to homeowners.

5. Social and Moral Imperative:- healthcare leaders are positioning their organizations to assume the social and moral imperative of reducing health inequity by focusing on the social determinants of health.

Assessing Social Determinants of Health in Your Patient Population

• implementation and action toolkit
•   evaluation tool
• Social Needs Screening Toolkit

Healthcare leaders recognize that it is vital to reform the system, so it is sustainable and accessible for all. Moreover, they understand that the social determinants of health are significant factors in this invaluable endeavor.

the Action Plan mainly operates in the following three priority areas:

• Social policy measures: improving income security and education, and decreasing unemployment and poor housing
• Strengthening the prerequisites for healthy lifestyles: measures to promote healthy behaviour of the whole population with special attention to disadvantaged groups where unhealthy behaviour is common
• Improving the availability and good quality of social and health care services for everyone.

To pursue these goals:-

• a follow-up system for health inequalities is developed
• knowledge about the scope of and trends in health inequalities is strengthened
• education and communication concerning health inequalities and their reduction is advanced.