Where your patients were born, where they work, where they play, and where they grow older all have a big impact on their health outcomes, with research showing that a person’s overall health is mostly driven by social, economic and environmental factors.
An education module offered via the AMA Ed Hub™ helps medical students, residents and physicians who may not have received this type of training during their medical school years grasp how these factors affect a patient’s health, how to ask patients the right questions about them, and how to help improve health outcomes and health equity for all patients.
The AMA Ed Hub is an online platform that brings together high-quality CME, maintenance of certification, and educational content—in one place with relevant learning activities, automated credit tracking and reporting for some states and specialty boards. The free online education module, “What are the Social Determinants of Health” is enduring material and designated by the AMA for a maximum of 0.5 AMA PRA Category 1 Credit™. It is one of 13 modules released as part of the Health Systems Science Learning Series.
Learn more about AMA CME accreditation.
What are social determinants of health?
While genetics are responsible for about 30% of a person’s health outcomes, research shows that five social and economic factors have a big influence too. And these factors, outlined below, are ones that have not traditionally been covered when health professionals gather information from patients.
Economic stability. Poverty, housing stability, food security and employment health. For centuries, there has been a strong link between poverty and poor health outcomes. Also, the unemployment rate affects domestic violence, depression, physical illness and substance abuse rates.
Education. Whether a person has graduated from high school or obtained a higher degree, access to quality early childhood education, and literacy also affect health outcomes. Understanding a patient’s literacy level can help you present information in a way they can understand.
Access to care. Health insurance coverage, health literacy and access to health care and primary care. For example, low health literacy may make it difficult to navigate the health system, resulting in worse outcomes and higher costs.
Community. Civic participation, discrimination, workplace conditions, incarceration and cohesion in a community. For example, social cohesion has been shown to result in lower mortality rates.
Neighborhood. This broad category covers housing, transportation, access to healthy foods, access to green space, a safe neighborhood, and air and water quality. Inadequate housing, dangerous streets and blighted neighborhoods have a negative impact on health.
What to ask in a clinical setting?
Physicians should ask questions beyond typical biological screening questions to determine how patients are impacted by social or economic factors.
For example, a poverty intervention tool starts with a single screening question: “Do you have difficulty making ends meet at the end of the month?” and follows with interventions the practice team may need to consider when managing that patient.
Once physicians know what socioeconomic factors may be at play, they can be ready to help by having reference materials on hand for patients—for example, where to receive local legal assistance or find nearby food pantries, shelters, translators, childcare services and nutritionists.
And physicians can integrate information they gather into the electronic health record to support research and communication between clinical practice teams and other service providers in the health care system or community.
