scholarly journals Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (22) ◽  
Author(s):  
Connie White-Williams ◽  
Laura P. Rossi ◽  
Vera A. Bittner ◽  
Andrea Driscoll ◽  
Raegan W. Durant ◽  
...  
Keyword(s):  
Heart Failure ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Healthcare Providers ◽  
Clinical Syndrome ◽  
Assessment Tools ◽  
Determinants Of Health ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Scientific Statement

Heart failure is a clinical syndrome that affects >6.5 million Americans, with an estimated 550 000 new cases diagnosed each year. The complexity of heart failure management is compounded by the number of patients who experience adverse downstream effects of the social determinants of health (SDOH). These patients are less able to access care and more likely to experience poor heart failure outcomes over time. Many patients face additional challenges associated with the cost of complex, chronic illness management and must make difficult decisions about their own health, particularly when the costs of medications and healthcare appointments are at odds with basic food and housing needs. This scientific statement summarizes the SDOH and the current state of knowledge important to understanding their impact on patients with heart failure. Specifically, this document includes a definition of SDOH, provider competencies, and SDOH assessment tools and addresses the following questions: (1) What models or frameworks guide healthcare providers to address SDOH? (2) What are the SDOH affecting the delivery of care and the interventions addressing them that affect the care and outcomes of patients with heart failure? (3) What are the opportunities for healthcare providers to address the SDOH affecting the care of patients with heart failure? We also include a case study ( Data Supplement ) that highlights an interprofessional team effort to address and mitigate the effects of SDOH in an underserved patient with heart failure.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

Abstract 262: The Impact of Social Determinants of Health on Heart Failure Readmission in a Veteran Population: A Single Center Study

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Sunita K Mahabir ◽  
Neal Olarte ◽  
Ana M Palacio
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
Determinants Of Health ◽  
Fiscal Year ◽  
Readmission Rates ◽  
Validated Questionnaire ◽  
The Impact

Background: Chronic heart failure (CHF) affects more than 5 million Americans and accounts for approximately 1 million hospitalizations annually. Readmission in CHF patients is associated with higher mortality and consumes a significant portion of hospital resources. Readmission rates may be higher when socioeconomic factors limit medication compliance and follow-up. In light of the high prevalence of CHF and the penalties associated with readmission rates, our study aims to identify factors that place our veterans with CHF at higher risk for readmission and in so doing, develop a profile for patients with a high risk of readmission that will benefit from focused intervention. Our goal is to use the information acquired in this study to reduce CHF readmission in the Miami VAMC by 10% over a 12-month period. Methods: This is an ongoing retrospective study conducted at the Miami VAMC. The Strategic Analysis for Improvement and Learning (SAIL) report was used to identify patients with CHF who were admitted to the Miami VAMC over fiscal year 2019 (FY19), the period from September 2018 to August 2019. Data was collected on various clinical baseline characteristics and social determinants of health from the patients' electronic health records for those admitted as well as for those with recurrent admissions within FY19. Using a previously validated questionnaire, identified patients will undergo further interview, in person or by phone, to identify social factors that may place them at higher risk for readmission. Results/Anticipated Results: A total of 185 patients were admitted during FY19 and of these, 38 had recurrent admissions. The mean time to readmission was 82 days. 76% of the patients readmitted had heart failure with reduced ejection fraction. Multiple co-morbidities were seen in the readmitted group, the commonest being hypertension (82%), diabetes (63%) and chronic kidney disease (39%). Thirty percent of those readmitted had a history of illicit drug use compared to 26% of those who were not readmitted. This population was also found to have multiple psychiatric co-morbidities - depression, anxiety and post-traumatic stress disorder. The odds of having one or more readmission within 12 months was 25% greater in those with psychiatric illness than in those without. Conclusion: Preliminary data analysis shows that psycho-social factors may play a role in recurrent admission in CHF patients. Further data will be collected to determine the impact of factors such as housing, education level and income on readmission risk so that patients at high risk can be identified and targeted with improved care co-ordination services to reduce this risk. As a unified health system, the VAMC is uniquely equipped with resources to address these disparities.

scholarly journals Riesgo de diabetes mellitus tipo 2 y sus determinantes

2022 ◽  
Vol 21 (1) ◽  
pp. 179-202
Author(s):  
Mariel Heredia ◽  
Esther Carlota Gallegos Cabriales
Keyword(s):  
Diabetes Mellitus ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Risk Indicators ◽  
Short Version ◽  
Cross Sectional ◽  
Factores De Riesgo

Objective: Describe the relationship between social determinants of health and risk of type 2 diabetes mellitus in Mexican population.Methods: This was a cross-sectional descriptive correlational study of a sample of 256 individuals from a rural community in Sinaloa, Mexico. Data collection was carried out from October 2020 to February 2021. A snowball non-probability sampling method was used. The Instruments used were the International Physical Activity Questionnaire (IPAQ), short version, the IPAQ-A for adults, the IPAQ-C for children, and a sociodemographic, anthropometric, and clinical data sheet.Results: The most frequent risk indicators for T2DM for adults are hypertension (81.7%) and overweight/obesity (68.6%); in children, it was overweight/obesity (34.9%). The risk of T2DM increased according to age (r = .560, p < .01) but decreased as education level increased (r = −.127, p < .05)Conclusions: The approach to T2DM risk factors from the perspective of social determinants of health allows strategic healthcare planning that considers the contextual factors associated with a lifestyle that reinforces the actions of healthcare providers. Objetivo: Describir la relación de los determinantes sociales de salud con el riesgo de DMT2 en población mexicana.Métodos: Estudio descriptivo correlacional transversal, con una muestra de 256 individuos de una comunidad rural de Sinaloa, México. La recolección de datos se realizó durante octubre de 2020 y febrero de 2021. El muestreo fue no probabilístico por bola de nieve. Los instrumentos utilizados fueron el cuestionario internacional de actividad física (IPAQ) versión corta, IPAQ-A, IPAQ-C y una hoja de registro datos sociodemográficos, antropométricos y clínicos.Resultados: Los indicadores de riesgo de DMT2 con mayor frecuencia para adultos fue padecer hipertensión arterial (81.7%) y SP/OB (68.6%) y para menores de edad fue tener SP/OB (34.9%). Resultó que el riesgo de DMT2 se acrecentaba según lo hacía la edad (r = .560, p < .01) pero disminuía al aumentar la escolaridad de las personas (r = -.127, p < .05).Conclusiones: El abordaje de factores de riesgo de DMT2 bajo la perspectiva de los DSS brinda la oportunidad de plantear estrategias de salud que contemplen factores contextuales simultáneos al estilo de vida que refuercen las acciones del personal de salud para contribuir a la reducción de los índices de morbimortalidad causados por la DMT2.

Abstract 14837: Social Determinants of Health and Outcomes in Patients With Advanced Heart Failure: Findings From PAL-HF

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vanessa Blumer ◽  
Joseph G Rogers ◽  
Christopher OConnor ◽  
Robert M Clare ◽  
Daniel B Mark ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Usual Care ◽  
Social Determinants Of Health ◽  
Clinical Outcomes ◽  
Social Determinants ◽  
Economic Security ◽  
Determinants Of Health ◽  
Anxiety And Depression ◽  
Anxiety Depression

Background: Social determinants of health (SDH) are associated with cardiovascular disease outcomes, but the overall influence of SDH on end-stage heart failure has not been well-described. Methods: In the Palliative Care in Heart Failure (PAL-HF) study, 150 advanced HF patients were randomized to usual care or usual care plus palliative care intervention. In the present analysis, quality of life (QoL) metrics [Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy (FACIT) Palliative care (PAL)], anxiety and depression (Hospital Anxiety and Depression Scale; HADS Depression, HADS Anxiety) and clinical outcomes (mortality, rehospitalization) were examined based on SDH (marital status, employment status, economic security, education level). For statistical analyses, patients were grouped per independent variable of interest in dichotomous categories (partner vs. no partner, employed/retired vs. unemployed, patient-reported economic constraints vs. no constraints, education beyond high school (HS) vs. less than HS). Repeated measures models were used to compare QoL metrics between SDH groups and Cox models for clinical outcomes. Results: At 6-month follow-up, having a partner, being employed, education beyond HS, and having economic security were not associated with better QoL or anxiety/depression metrics in advanced HF patients. Unemployment and education less than HS were associated with increased 6-month rehospitalization (both p=0.03). SDH measures were not associated with mortality (all p>0.05) (Table). Conclusions: In this analysis of PAL-HF patients, SDH were not associated with improved QoL or anxiety/depression metrics over 6 months. However, being employed and education beyond HS were associated with reduced rehospitalization. Further studies accounting for SDH are needed to better determine how these factors should be incorporated into palliative care interventions in advanced HF.

scholarly journals Heart failure and social determinants of health in Thailand: An integrative review

Heliyon ◽  
2019 ◽  
Vol 5 (5) ◽  
pp. e01658 ◽  
Author(s):  
Thitipong Tankumpuan ◽  
Reiko Asano ◽  
Binu Koirala ◽  
Cheryl Dennison-Himmelfarb ◽  
Siriorn Sindhu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Integrative Review

scholarly journals Black Nurses Collaborative Approach to Addressing COVID-19 in Black Communities

2021 ◽  
Author(s):  
Martha A. Dawson
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Healthcare Providers ◽  
Well Being ◽  
Health Protection ◽  
Determinants Of Health ◽  
Black Communities ◽  
Healthcare Waste ◽  
Black Nurses ◽  
The Usa

AbstractAs with other national disasters, epidemics, and pandemics, the novel coronavirus SARS-CoV-2 (COVID-19) pandemic has highlighted health disparities in Black communities in the USA. Healthcare providers, community activists, politicians, members of faith-based organizations, professional athletes, and Black families are asking crucial questions about why Black and Brown people are disproportionately infected by, and dying from, the COVID-19. Evidence in healthcare and social sciences literature demonstrates that historically, systemic racism and injustices play a large role in the health and well-being of Blacks living in the USA. For decades, the National Black Nurses Association has been on the forefront, engaging our people using a collaborative community-based practice model. The healthcare goal in the USA should center on health protection, promotion, and prevention, moving toward a wellness model and away from treatment of illnesses that contribute to healthcare waste. Finally, awareness of social determinants of health has taken center stage, demonstrating how laws, policies, and practice affect health outcomes and the well-being of Black and Brown communities. In order to address social determinants of health and healthcare inequity, the National Black Nurses Association has called for an increase in the number of Black registered nurses and licensed vocational and practical nurses. The healthcare goal in the USA should center on health protection, promotion, and preventions moving toward a wellness model and away from treatment of illnesses that contributes to healthcare waste.

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