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“Why has the U.S. health care system paid so little attention to social determinants of health, and what evidence do you see of this changing?”
Be prepared to discuss in class.
Please refer to your textbook.
The United States has lagged behind other countries in addressing the effects of socioeconomic status on health outcomes. We have a lot of work to do, but I think it’s getting more attention now than ever before.
Social determinants of health are important, but they are not the only thing that matters. The U.S health care system is starting to pay attention to social determinants of health, but it’s not enough.
The United States has spent more than $1 trillion on its health care system since 1960 and has been ranked as one of most expensive systems in the world–and yet we continue to have some of the highest rates of infant mortality, maternal mortality and rates for people suffering from diabetes or heart disease compared with other developed countries like Canada or France (where healthcare costs about $4,000/year per person).
Social determinants of health are the social, economic and environmental circumstances in which people are born, grow, live, work and age that directly influence their health and well-being. These include income and education; employment; housing; social exclusion; gender and sexual orientation.
In a 2010 report entitled The State of Social Determinants of Health in Canada (SSDH), a Canadian research team found that “the most significant contributors to the health disparities experienced by certain groups within our society are related to their socioeconomic status.” They also found that there was an association between low education levels or income level with higher rates of hospitalization for chronic conditions such as diabetes mellitus type 2 (DM2).
The social determinants of health (SDoH) are the circumstances that influence our health status, such as income, education, and employment. These factors have been identified as key drivers of health disparities in the U.S., but they also impact individuals’ lives on a daily basis. To illustrate this point: when you’re hungry at work or stressed about paying your bills because of low wages, it can affect your ability to focus on what needs to be done at work and how much time is left before payday comes around again–or even cause stress-related illnesses like heart disease or diabetes later down the line!
So while SDoHs aren’t always visible in their current state (in part because they haven’t been studied as much), there is evidence showing how important they are for populations:
As you might expect, the United States is not alone in this problem. However, no country’s health care system pays enough attention to them. For example, we know that poverty and unemployment are associated with poor health outcomes and that both of these factors can be reduced by improving social determinants of health (SDS). However, there has been little research done on how best to do so.
In fact, one reason why we haven’t seen much progress in this area is because researchers have been working under the assumption that if they just give people money or healthcare instead of paying attention to SDS then they will improve their lives–but this isn’t true!
There have been many efforts to change that, but they have often faltered because no one has been able to agree about what should be done or how. In the absence of agreement on policies and programs, it can be difficult for leaders within organizations or across governments to develop the leadership skills needed to make progress on this issue.
I think there has been some progress made recently as many people now understand that social determinants of health need to be addressed more than ever before in this era of aging populations, rising costs and increasing burden of chronic disease.
However, I believe we are still far from where we need to be when it comes to improving the health of our communities by combating poverty and inequality. We need to keep working on this issue so that all Americans can access affordable quality care which will help them live longer with fewer burdensome responsibilities on their shoulders.
The United States has lagged behind other developed countries in addressing the effects of socioeconomic status on health outcomes. While the United States has a higher rate of poverty than other developed countries, it also has a lower life expectancy than those countries.
The U.S., along with most industrialized nations, spends more money per capita on health care than any other country–but this does not guarantee better health outcomes for all Americans. In fact, research shows that even if you’re uninsured or underinsured and can’t afford treatment paid for by insurance companies or Medicaid (the government program for low-income families), your chances of getting good care are still very high: according to one study from Harvard University Medical School published in 2010 in Annals Of Internal Medicine, 90% of U.S.-based physicians will accept new patients who have no health insurance at their discretion!
We are starting to pay more attention to social determinants of health, and that’s a good thing. But we must continue to work together as communities, clinicians, researchers and policy makers if we want to make the most out of this opportunity.
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