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.

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.

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 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

scholarly journals Creation and Validation of a Polysocial Score for Mortality Among Community-Dwelling Older Adults in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 164-164
Author(s):  
Yongjing Ping ◽  
Chenkai Wu ◽  
Michelle Odden ◽  
Robert Stawski ◽  
Hoda Magid
Keyword(s):  
Older Adults ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
The United States ◽  
Community Dwelling ◽  
Determinants Of Health ◽  
Stepwise Logistic Regression ◽  
Social Environments ◽  
Social Interventions

Abstract The interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. Since the older population had highly diverse social backgrounds, a new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Participants ([n = 7383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the Health and Retirement Study (HRS) at study entry in 2006 or 2008. Social determinants of health encompassing five social domains: economic stability, neighborhood and physical environment, education, community and social context, and health care system. Five-year mortality was calculated as the number of years from the interview date to the death date. We used the forward stepwise logistic regression to construct the polysocial score and multivariate logistic regressions to assess the associations between polysocial score and five-year mortality. Polysocial score (range: 7 to 59, mean±SD: 35.5±7.5) was created using 15 social determinants of health. Of the 7383 participants, 491 (30.8%), 599 (17.2%), and 166 (7.8%) deaths occurred over five years among participants with a low (0-29), intermediate (30-39), and high (40+) polysocial score, respectively. Participants with an intermediate (Odds Ratio [OR]=0.76; 95% CI, 0.65-0.89) or high (OR=0.46; 95% CI, 0.36-0.59) polysocial score had higher odds of death than those in the low category in the fully adjusted model, respectively. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older adults to improve their social status for specific health outcomes.

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.

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