What are the key social determinants of health?


Access to healthcare is not uniform across socioeconomic lines. Many factors influence not only how readily available medical treatment is, but also different demographics’ and populations’ overall health.

While there is a great deal of personal responsibility in healthcare and maintaining patient well-being, not to mention genetic factors to account for, there are forces outside our control that dictate how healthy we all are. Environmental factors have a profound impact on our lifestyle choices, like our daily eating habits, as well as the availability of preventive care options.

According to GoInvo, two-thirds (67%) of health outcomes are driven by factors beyond genetics and quality of medical care,  including social circumstances, individual behavior, and environment.

Social determinants are a key consideration when providing the best healthcare possible, and managed care organizations need to address them to improve patient outcomes and enhance the member experience.

Poverty reduces individual health status

The link between wealth and healthcare is typically viewed primarily ⁠— if not solely ⁠— through the lens of treatment and medication costs. But that doesn’t tell the full story of how wealth ⁠— or the lack thereof ⁠— impacts health outcomes for individuals or entire populations.

The Centers for Disease Control and Prevention identifies poverty as one of the most significant social determinants of health, noting that people living in poorer neighborhoods and communities sometimes lack adequate access to amenities that promote healthy lifestyles and improve health status.

Low-income areas are more likely to be located within so-called “food deserts” where access to affordable and nutritional food is limited. It’s incredibly difficult for residents to maintain healthy eating habits when fresh produce is scarce or prohibitively expensive. They may be more likely to regularly eat readily available food that is high in fat, sugar, sodium, and other ingredients that could increase health risks.

According to figures published by the U.S. Census Bureau in 2017, 12.3% of the U.S. — nearly 40 million people ⁠— lives below the poverty line. Other estimates place it at 13.9%.

Needless to say, a significant number of people in this country struggle to obtain nutritional food and maintain healthy eating habits that would help improve their long-term health outcomes.

Location impacts healthcare access

Where people live has a dramatic effect on their health status and ability to access reliable preventive care and treatment. This is an issue that can affect both rural and urban communities, for different reasons.

Rural towns often have far fewer healthcare options than communities near or in large urban areas. Small towns may only have one or two primary care physicians working nearby, and it’s not unusual for rural residents to travel large distances to see a medical specialist.

According to the CDC, approximately 60 million people live in rural communities in the U.S., about 19.3% of our population.

That seclusion is an obvious concern for medical emergencies that require immediate intervention, but it’s also an impediment for more routine treatments and chronic ailment care. Many treatment sessions, while not considered emergency care, are still critically important to the well-being and long-term health of a patient. Dialysis sessions and chemotherapy are examples of non-emergency care that have obvious repercussions if not diligently attended.

Other medical appointments ⁠— physical therapy, mental health therapy, drug abuse consultation, annual physicals ⁠— may not cause immediate health concerns if missed, but will have serious negative consequences for patients who skip them.

Support better health outcomes with reliable NEMT

Non-emergency medical transportation (NEMT) is a major boon for people living in these rural communities, especially individuals who lack access to reliable transportation or are not able to operate a vehicle. People living in rural communities may find their NEMT options limited.

Available vehicles may not account for health factors like a patient being wheelchair-bound or requiring a medical stretcher to ride to and from their appointments. Due to the large distances covered between patient and facility, reliability is another concern. Can transportation providers consistently pick up and drop off members according to their schedules? Trip delays have cascading effects for patients, transportation providers, and hospitals alike, resulting in missed appointments and deferred treatment.

Working with a reliable NEMT manager can help address these social determinants and deliver better health outcomes for Medicaid and MCO members. Modivcare supports more transportation options that account for different demographics, and is committed to providing the best quality of service and care possible.  

SOURCES: https://www.cdc.gov/publichealthgateway/nphps/index.html