Social Determinants In Health Care

In CPH 387 thus far, we have discussed and built a foundation to help us understand health disparities and health equity, as well as why health equity is important for everyone. Considering that the United States spend more per capita on healthcare than any other developed nation, yet continues to have subpar overall health scores throughout our populations (David Squires, Chloe Anderson, U.S. Healthcare from A Global Perspective), describes a deep-seeded health inequality, which results in fewer health benefits throughout. It has been researched and can be seen that, throughout countries considered more equal, health disparities overall decrease, and more benefits arise, such as higher educational scores, lower morbidity and mortality rates,
Health determinants can be divided into two categories: physical determinants and social determinants. These determinants are factors that contribute to a person’s overall state of health, and include biological, socioeconomic, psychological, social, and behavior factors. Typically, the physical determinants are broken down into biology and genetics, such as sex and age, individual behaviors, such as alcohol and drug use or unprotected sex, social environment factors like discrimination or income, physical environment, like where a person lives, the weather, water quality, and built environment, as well as health services and access to health care and insurance. The social determinants of health include social and economic systems responsible for health inequities, like the social environment, health services, and structural or societal factors, often shaped by distribution of money, power, and resources throughout local communities, nations, and the world. In summary, these determinants are a combination of where we live, work, and play, and include transportation, access to markets, banks, quality education, and safe neighborhoods, community integration and social support, culture, language, policy, and racism (Determinants of Health,
Calman lectured us ‘medicine’s assault on people of color’, and more vaguely, the present racial and ethnic disparities that exist in health care in the Bronx, and presumably across the globe. In more detail, he discussed disparities that his specific patients faced, including assumptions (due to implicit biases) that he made through his time being a doctor, assumptions based off of fears, implicit biases, and racial prejudices. “I cannot provide Mr. North with all that…institutions have to offer. He knows that. He has often tried to teach me that, and just as often is amazed that I am unable to accept it…The same considerations my family or I would receive are rarely given to him…There is absolutely no doubt that Mr. North is treated differently than my white, middle-class patients are treated.” (Out of the Shadows, Dr. Neil Calman) This passage from Dr. Calman’s article ‘Out of the Shadows’ is a perfect example of just some of the discrimination that is apparent in the healthcare field for those such as men of color, created not by accident, but by design throughout the healthcare