scholarly journals Social determinants of health exacerbate disparities in COVID-19 illness severity and lasting symptom complaints

2021 ◽  
Author(s):  
Moriah Thomason ◽  
Cassandra L Hendrix ◽  
Denise Werchan ◽  
Natalie H Brito
Keyword(s):  
Health Outcomes ◽  
Medical Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Perceived Discrimination ◽  
Illness Severity ◽  
Determinants Of Health ◽  
Neural Systems ◽  
Symptom Complaints

BACKGROUND: Increasing reports of long-term symptoms following COVID-19 infection, even among mild cases, necessitates systematic investigation into the prevalence and type of lasting illness. Notably, there is limited data regarding the influence of social determinants of health, like perceived discrimination and economic stress, which may exacerbate COVID-19 health risks. The primary goals of this study are to test the bearing of subjective experiences of discrimination, financial security, and quality of care on illness severity and lasting symptom complaints. METHODS: 1,584 recovered COVID-19 patients that experienced mild to severe forms of the disease provided information about their illness, medical history, lasting symptoms, and psychosocial information. Prevalence data isolated differences in patients infected early versus late in the pandemic. Path analyses examined hypothesized associations between discrimination, illness severity, and lasting symptoms. Post hoc logistic regressions tested social determinants hypothesized to predict neurological, cognitive, or mood symptoms. RESULTS: 70.6% of patients reported presence of one or more lasting symptoms after recovery. Neural systems were especially impacted, and 19.4% and 25.1% of patients reported mood or cognitive/memory complaints, respectively. Path models demonstrated that frequency and stress about experiences of discrimination predicted increased illness severity and increased lasting symptom count, even when adjusting for sociodemographic factors and mental/physical health comorbidities. Notably, this effect was specific to stress related to discrimination, and did not extend to general stress levels. Further, perceived but not objective socioeconomic status (SES) was associated with increased lasting symptom complaints after recovery. Finally, associations between discrimination and illness differed with individual perceptions about quality of medical care. CONCLUSIONS: Lasting symptoms after recovery from COVID-19 are highly prevalent and neural systems are significantly impacted. Importantly, psychosocial factors (perceived discrimination and perceived SES) can exacerbate individual health risk. This study provides actionable directions for improved health outcomes by establishing that sociodemographic risk and medical care influence near and long-ranging health outcomes.

scholarly journals Frameworks and inequalities in healthcare: some applications

2021 ◽  
pp. 115-120
Author(s):  
Pietro Renzi ◽  
Alberto Franci
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Inequalities ◽  
Economic Status ◽  
Determinants Of Health ◽  
Health Determinants ◽  
Quadrant Analysis ◽  
Inequality Measures ◽  
Health Objectives

Background Social determinants of health (SDOH) have increasingly entered health policy conversations as a growing body of researches, reveal the direct relationship between social determinants and health outcome. In fact, the recent literature is moving from the traditional model that focus on how health affects economic status, to a new view that economic status affects health. Objectives To investigate the principal conceptual frameworks for action on social determinants of health. Another aim is to contribute on the ongoing discourse on feasible measures which could be used to alert regions to inequalities in the distribution of health. Methodology, Italian data are used as a demonstration. Quadrant charts illustrate associations between how much regions spend on health and how effectively health system functions. The relevant inequality measures are used to rank health inequalities. Main results Frameworks have been presented to help communities, health professionals and others begin to better understand and address a variety of factors that affects health. Quadrant analysis technique shows the extent to which spending more on health, translates into better health outcomes, higher quality of care and improve access to care across the Italian regions, whilst also recognition the importance of major risk factors. Conclusions The social inequalities in health and what this means for how we understand and reduce them, as not to date been compressively examined empirically. There is an urgent need to expand our knowledge with comparable data on health determinants and more refined health outcomes. Furthermore, there is a need for feasible inequality measures in the health information systems. The measures used in this study, provide a step to inform and guide the uptake of equity-sensitive policies.

scholarly journals Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association

Circulation ◽  
2020 ◽  
Vol 141 (10) ◽  
Author(s):  
Robert A. Harrington ◽  
Robert M. Califf ◽  
Appathurai Balamurugan ◽  
Nancy Brown ◽  
Regina M. Benjamin ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Rural Health ◽  
Social Determinants ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Determinants Of Health ◽  
Rural Populations ◽  
Call To Action

Understanding and addressing the unique health needs of people residing in rural America is critical to the American Heart Association’s pursuit of a world with longer, healthier lives. Improving the health of rural populations is consistent with the American Heart Association’s commitment to health equity and its focus on social determinants of health to reduce and ideally to eliminate health disparities. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders to make rural populations a priority in programming, research, and policy. This advisory first summarizes existing data on rural populations, communities, and health outcomes; explores 3 major groups of factors underlying urban-rural disparities in health outcomes, including individual factors, social determinants of health, and health delivery system factors; and then proposes a set of solutions spanning health system innovation, policy, and research aimed at improving rural health.

Neighborhood Considerations for Social Determinants of Health and Risk

2017 ◽  
Author(s):  
Holley A. Wilkin
Keyword(s):  
Social Support ◽  
Social Networks ◽  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Communication Infrastructure ◽  
The Social ◽  
Action Context ◽  
Communication Infrastructure Theory

When it comes to health and risk, “place” matters. People who live in lower-income neighborhoods are disproportionately affected by obesity and obesity-related diseases like heart disease, hypertension, and diabetes; asthma; cancers; mental health issues; etc., compared to those that live in higher-income communities. Contributing to these disparities are individual-level factors (e.g., education level, health literacy, healthcare access) and neighborhood-level factors such as the socioeconomic characteristics of the neighborhood; crime, violence, and social disorder; the built environment; and the presence or absence of health-enhancing and health-compromising resources. Social determinants of health—for example, social support, social networks, and social capital—may improve or further complicate health outcomes in low-income neighborhoods. Social support is a type of transaction between two or more people intended to help the recipient in some fashion. For instance, a person can help provide someone who is grieving or dealing with a newly diagnosed health issue by providing emotional support. Informational support may be provided to someone trying to diagnose, manage, and/or treat a health problem. Instrumental support may come in the help of making meals for someone who is ill, running errands for them, or taking them to a doctor’s appointment. Unfortunately, those who may have chronic diseases and require a lot of support or who otherwise do not feel able to provide support may not seek it due to the expectation of reciprocity. Neighborhood features can enable or constrain people from developing social networks that can help provide social support when needed. There are different types of social networks: some can enhance health outcomes, while others may have a more limiting or even a detrimental effect on health. Social capital results in the creation of resources that may or may not improve health outcomes. Communication infrastructure theory offers an opportunity to create theoretically grounded health interventions that consider the social and neighborhood characteristics that influence health outcomes. The theory states that every neighborhood has a communication infrastructure that consists of a neighborhood storytelling network—which includes elements similar to the social determinants of health—embedded in a communication action context that enables or constrains neighborhood storytelling. People who are more engaged in their neighborhood storytelling networks are in a better position to reduce health disparities—for example, to fight to keep clinics open or to clean up environmental waste. The communication action context features are similar to the neighborhood characteristics that influence health outcomes. Communication infrastructure theory may be useful in interventions to address neighborhood health and risk.

scholarly journals The potential value of social determinants of health in predicting health outcomes

2018 ◽  
Vol 25 (8) ◽  
pp. 1109-1110
Author(s):  
Jessica S Ancker ◽  
Min-Hyung Kim ◽  
Yiye Zhang ◽  
Yongkang Zhang ◽  
Jyotishman Pathak
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Potential Value

Social determinants of health in male forensic patients admitted at a tertiary psychiatric hospital in South Africa

2021 ◽  
pp. 002076402110602
Author(s):  
Keabetswe Mogase ◽  
Tshepiso Moeketsi ◽  
Funeka B Sokudela
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
Psychiatric Patients ◽  
Determinants Of Health ◽  
Main Stream ◽  
Multivariate Statistical ◽  
Black African ◽  
Forensic Patients

Introduction: Social factors are increasingly being used to determine health outcomes. The concept of social determinants of health has been used to shape policies that address disparities. There is a paucity of such studies in the forensic setting. This study aimed to use social determinants of health to identify social factors that are associated with being a male forensic patient. Methods: The study was a retrospective two-group (forensic and non-forensic) comparison clinical record review. Association was identified through independent and multivariate statistical analysis. Results: The study sample comprised of 296 patients, 56.4% ( n = 167) of which were non-forensic. The majority of the sample was black African, 50 years and older, single, unemployed and had attended main-stream schooling. Race ( p < .01), employment status ( p < .02), not completing high school ( p < .01), previous imprisonment ( p < .01), drug use ( p < .01) and not being on medication prior to admission ( p < .01) were significantly associated with being a forensic patient. Multivariate logistic regression analyses also confirmed these associations. Conclusion: Social determinants of health ought to be targeted to improve health outcomes of psychiatric patients. Collaborations between mental health, public health, law and policy makers as well as non-/governmental agencies may lead to change. Human rights of individuals with mental illness may thus be enhanced in the long run.

Call to Action: Addressing Social Determinants of Health in Pharmacy Practice

2021 ◽  
pp. 106002802110408
Author(s):  
Julie Kalabalik-Hoganson ◽  
Ayse Elif Ozdener-Poyraz ◽  
Denise Rizzolo
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Health Risks ◽  
Social Determinants ◽  
Pharmacy Practice ◽  
Social Needs ◽  
Determinants Of Health ◽  
Call To Action ◽  
Physician Practices ◽  
The Impact

Social determinants of health (SDOH) are conditions in which individuals are born, live, work, learn, play, and age that affect health, risks, functioning, and outcomes. SDOH are recognized barriers to care, risk factors for certain diseases, and associated with poorer health outcomes. Screening for SDOH in physician practices and hospitals is reportedly low. The accessibility of pharmacists and established relationships with patients make pharmacy settings ideal for identifying and mitigating social needs. An evaluation of the impact of SDOH on health outcomes and opportunities for pharmacists to embed screening into practice is warranted.

scholarly journals Quality of life of men with AIDS and the model of social determinants of health

2015 ◽  
Vol 23 (2) ◽  
pp. 183-191 ◽  
Author(s):  
Gilmara Holanda da Cunha ◽  
Maria Luciana Teles Fiuza ◽  
Elucir Gir ◽  
Priscila de Souza Aquino ◽  
Ana Karina Bezerra Pinheiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Cross Sectional Study ◽  
Determinants Of Health ◽  
University Hospital ◽  
Cross Sectional ◽  
Institutional Review ◽  
One Year

OBJECTIVE: to analyze the quality of life (QoL) of men with AIDS from the perspective of the model of social determinants of health (MSDH). METHOD: cross-sectional study conducted in an outpatient infectious diseases clinic from a Brazilian university hospital over the course of one year with a sample of 138 patients. A form based on the MSDH was used to collect sociodemographic data addressing individual, proximal, intermediate determinants and the influence of social networks together with an instrument used to assess the QoL of people with HIV/AIDS. The project was approved by the Institutional Review Board (Protocol No. 040.06.12). RESULTS: according to MSDH, most men with AIDS were between 30 and 49 years old (68.1%), mixed race (59.4%), heterosexual (46.4%), single (64.5%), Catholic (68.8%), had a bachelor's degree (39.2%), had no children (61.6%), and had a formal job (71.0%). The perception of QoL in the physical, level of independence, environment, and spirituality domains was intermediate, while QoL was perceived to be superior in the domains of psychological and social relationship. A perception of lower QoL was presented by homosexual (p=0.037) and married men (p=0.077), and those with income below one times the minimum wage (p=0.042). A perception of greater QoL was presented by those without a religion (p=0.005), living with a partner (p=0.049), and those who had a formal job (p=0.045). CONCLUSION: social determinants influence the QoL of men with AIDS.

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