An individual’s health is impacted not only by factors such as genetics and lifestyle, but also by a group of factors collectively referred to as social determinants of health. These factors, which are responsible for the majority of health disparities, include the social and physical environment, such as housing, income, education, and access to health services. These health determinants are shaped by the distribution of power and wealth at the local, national, and global levels1,2. Since these factors are largely outside of the control of individuals and since they can significantly impact health, there is a need for careful monitoring of both the conditions related to social determinants and the actions taken by leaders to address them. Intersectoral actions, which refer to actions taken resulting from a collaboration among leaders in two or more policy sectors aimed at achieving a common goal, should be particularly subject to scrutiny since they may be outside the control of the healthcare sector yet can greatly influence the sector. For example, multiple policy sectors may develop initiatives to improve air quality in relation to transportation3. These initiatives may ultimately affect healthcare and the health of residents due to the relationship between poor air quality or pollution and respiratory problems.

     Another important issue is that in spite of the recognition by care providers and policy makers that social and environmental factors can significantly impact health, care providers do not routinely screen for social determinants in patients2. One reason for the lack of standardized screening efforts may be the inability to create positive changes, given the lack of control over such factors. One possible solution is that if an issue related to a social determinant of health cannot be appropriately handled by a primary care provider or social worker, the patient could be referred to a legal expert for representation to address the problem through legal means. Efforts to eliminate health inequities due to social determinants of health must be collaborative, involving not only healthcare providers and patient advocates, but also members of all major policy sectors in society.

References

1. Centers for Disease Control and Prevention. (2014). Definitions. Retrieved from https://www.cdc.gov/nchhstp/socialdeterminants/definitions.html.

2. Theiss, J., & Regenstein, M. (2017). Facing the need: Screening practices for the social determinants of health. Journal of Law, Medicine & Ethics, 45(3), 431-441. doi:10.1177/1073110517737543

3. Pega, F., Valentine, N. B., Rasanathan, K., Hosseinpoor, A. R., Torgersen, T. P., Ramanathan, V., & … Neira, M. P. (2017). The need to monitor actions on the social determinants of health. Bulletin of the World Health Organization, 95(11), 784-787. doi:10.2471/BLT.16.184622

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