scholarly journals Associations of adverse social determinants of health with missed well-child visits and the role of caregiver social support

2021 ◽  
Vol 4 (1) ◽  
pp. 067-072
Author(s):  
Roberts William ◽  
Kim Eun Ji ◽  
Martinez Johanna ◽  
Uwemedimo Omolara Thomas
Keyword(s):  
Social Support ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Screening Program ◽  
Secondary Data ◽  
Financial Hardship ◽  
Determinants Of Health ◽  
Housing Instability ◽  
Unstable Housing ◽  
High Social Support

Objective: To examine the association between adverse social determinants of health (SDH) and missed well-child visits and the interaction with the level of caregiver social support. Methods: This is a secondary data analysis of data collected from a SDH screening program conducted during well-child visits with referral, navigation and follow-up services for patients. We included 573 adult caregivers who accompanied patients aged 0-5 years to well-child visits and completed the screening from August 2017 to May 2018. The caregivers reported financial hardship, food insecurity, housing challenges, childcare difficulty, transportation issues, insurance difficulty, job difficulty, and education needs. Our primary outcome was a no-show (i.e., missed) to a well-child visit. Social support was dichotomized as low or high. Results: Among 573 patients who completed the screening, 335 patients (76.4%) had at least one social need. Financial hardship (p = 0.006), housing instability (p = 0.002), and no/poor childcare (p = 0.03) were associated with missed well-child visits. In multivariable regression analysis, having Medicaid (aOR = 1.91 [1.17-3.10]) and unstable housing (aOR = 6.79 [1.35-34.70]) were both associated with missed well-child visits. However, when social support was added to the multivariable logistic model, both Medicaid and unstable housing were no longer associated with missed well-child visits. Conclusion: Adverse SDH such as financial hardship, housing instability, and childcare difficulty were associated with missed well-child visits. However, with the addition of social support, this association was no longer significant. This study supports the hypothesis that high social support may mitigate the association between well-child visits among families experiencing adverse SDH.

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 Relevance of Gender and Social Support in Self-Rated Health and Life Satisfaction in Elderly Spanish People

2019 ◽  
Vol 16 (15) ◽  
pp. 2725 ◽  
Author(s):  
M. Pilar Matud ◽  
M. Concepción García ◽  
Demelza Fortes
Keyword(s):  
Social Support ◽  
Life Satisfaction ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Determinants Of Health ◽  
High Educational Level ◽  
Cross Sectional ◽  
Self Rated Health

Background: Gender and social support are important social determinants of health, but the relevance of such variables in older people’s health has raised less scholarly attention than in younger age groups. This study examines the relevance of gender and social support in the self-rated health and life satisfaction of elderly Spanish people. A cross-sectional study with a sample of 702 men and 754 women aged between 60 and 94 years was conducted. All participants were evaluated through questionnaires that assess gender role traits, social support, and life satisfaction. Results: Men scored higher than women in masculine/instrumental trait and in life satisfaction whereas women scored higher than men in feminine/expressive trait. Results from multiple regression analyses indicated that women and men presenting higher social support had better self-rated health and higher life satisfaction. High scores in masculine/instrumental trait also proved to be an important predictor of men’s and women’s high life satisfaction and of women’s better self-rated health, whereas the high feminine/expressive trait predicted better self-rated health in the men group. A high educational level was associated in the women’s group with better self-rated health and higher life satisfaction. Conclusions: We conclude that gender and social support are important social determinants of health among older people.

scholarly journals Social Determinants of Myocardial Infarction Risk and Survival: A Systematic Review

2020 ◽  
pp. 1-12
Author(s):  
Steven S. Coughlin ◽  
Steven S. Coughlin ◽  
Lufei Young
Keyword(s):  
Myocardial Infarction ◽  
Social Support ◽  
Socioeconomic Status ◽  
Social Determinants Of Health ◽  
Low Socioeconomic Status ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Access To Health Services ◽  
Immigration Status ◽  
Increased Risk

Social determinants of health that have been examined in relation to myocardial infarction incidence and survival include socioeconomic status (income, education), neighbourhood disadvantage, immigration status, social support, and social network. Other social determinants of health include geographic factors such as neighbourhood access to health services. Socioeconomic factors influence risk of myocardial infarction. Myocardial infarction incidence rates tend to be inversely associated with socioeconomic status. In addition, studies have shown that low socioeconomic status is associated with increased risk of poorer survival. There are well-documented disparities in myocardial infarction survival by socioeconomic status, race, education, and census-tract-level poverty. The results of this review indicate that social determinants such as neighbourhood disadvantage, immigration status, lack of social support, and social isolation also play an important role in myocardial infarction risk and survival. To address these social determinants and eliminate disparities, effective interventions are needed that account for the social and environmental contexts in which heart attack patients live and are treated.

scholarly journals Social support of people with HIV/AIDS: the Social Determinants of Health Model

2018 ◽  
Vol 71 (suppl 1) ◽  
pp. 625-630 ◽  
Author(s):  
Vanessa da Frota Santos ◽  
Samyla Citó Pedrosa ◽  
Priscila de Souza Aquino ◽  
Ivana Cristina Vieira de Lima ◽  
Gilmara Holanda da Cunha ◽  
...  
Keyword(s):  
Social Support ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Emotional Support ◽  
Determinants Of Health ◽  
Instrumental Support ◽  
Cross Sectional ◽  
The Social ◽  
Health Model ◽  
Hiv Aids

ABSTRACT Objective: To analyze the social support of people with HIV/AIDS from the perspective of the Social Determinants of Health Model. Method: This was a cross-sectional study conducted in 2015 in an infectious disease outpatient clinic. The sample was made up of 116 people with HIV/AIDS. The data was collected through interviews, using a sociodemographic form and a social support scale. The data was analyzed using descriptive statistics, and Student’s t-tests and Mann-Whitney tests were performed to determine the association between social support and the social determinants of health. Results: Total social support was satisfactory, emotional support was influenced by smoking (p=0.0432) and instrumental support, by the number of people in the household (p=0.0003). The main source of instrumental and emotional support was relatives living outside the household, corresponding to 66.7% and 56.1%, respectively. Conclusion: It was found that smokers havelower emotional support and people living alone received less instrumental support.

scholarly journals 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes

2020 ◽  
Vol 4 (s1) ◽  
pp. 89-90
Author(s):  
Lauren Devore Nephew ◽  
Susan Rawl ◽  
Archita Desai ◽  
Eric Orman ◽  
Marwan Ghabril ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Hepatocellular Carcinoma ◽  
Socioeconomic Status ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
T Score ◽  
The Impact

OBJECTIVES/GOALS: Achieving therapy for hepatocellular carcinoma (HCC) involves navigating through a complex cascade of care. Non-HCC cancer mortality has been associated with social determinants of health outside of cancer specific risk. Our objective is to explore the impact of social determinants on HCC outcomes. METHODS/STUDY POPULATION: Patients with HCC were enrolled from 3 hospitals form June, 1 2019 to December 1, 2019. A chart review was done to collect information on liver disease severity and cancer stage. Patients were interviewed to collect information on the following: 1) socioeconomic status (income, education, insurance status, and employment status), 2) literacy (Rapid Estimate of Adult Literacy in Medicine (REALM-R) and Brief Health Literacy Screening Tool (BREIF)), 3) social support (Patent Reported Outcome Measurement Information System (PROMIS) instrumental and information support tool), 4) quality of life (PROMIS global and mental health tool), 5) substance abuse, and 6) linkage to care. RESULTS/ANTICIPATED RESULTS: Data compiled on the social determinants of health revealed (n = 35): 1) 60.0% of patients had incomes below $30,000 per year, 60.0% of patients had not gone past high school for education, and 8.6% had full time employment, 2) the average BREIF score was 10.3 (range 3-15)(4-12 indicate limited literacy). The average REALM-R score was 5.5 (range 0-8) (<6 indicate at risk for poor literacy), 3) patients had strong instrumental (T score 61.4±7.1) and information social support (T score 64.6±4.7) (mean T scores calibrated to a general population mean of 50), 4) patients had poor mental (T score 43.7 ±6.5) and physical quality of life (T score 46.6 ±9.9), 5) 25.7% of patients reported alcohol use in the past 90 days 6) 80.0% of patients reported that their doctor had spoken to them about liver transplantation. DISCUSSION/SIGNIFICANCE OF IMPACT: This patient population was well linked to care with good social support. However their literacy, socioeconomic status, mental and global health was poor and substance use history complex. Continued follow up of this cohort is planned to determine how these factors might impact their ability to navigate through the care cascade as well as survival.

scholarly journals 629. Understanding the Effects of Social Determinants of Health on Outcome When Discharging Veterans on Parenteral Antibiotic Therapy

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S375-S375
Author(s):  
Erin Guenther ◽  
Katherine Sherman ◽  
Haroon Shah ◽  
Claire Dysart ◽  
Nathan Gundacker
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Illicit Drugs ◽  
Determinants Of Health ◽  
Mental Health Diagnosis ◽  
Parenteral Antibiotic ◽  
Race Ethnicity ◽  
Health Diagnosis

Abstract Background Social determinants of health are conditions in which people live, including aspects of both social environments and physical environments, and how these conditions affect their health. Examples of social determinants include access to health care, social support, culture, etc. These factors are often considered when discharging a patient on IV antibiotics. The purpose of this study was to determine if social determinants of health are related to outcomes for veterans discharged from the Zablocki VA on outpatient parenteral antibiotic therapy (OPAT). Methods This retrospective chart review evaluated veterans discharged home from the Zablocki VA on OPAT between the years of 2013 and 2017. Variables of social determinants of health included: race/ethnicity, co-habitants, mental health diagnosis, employment, use of illicit drugs, use of tobacco, and use of alcohol. The primary outcome analyzed was completion of therapy with or without complication. Complication is defined as antibiotic change/dose adjustment, PICC line complication, or additional clinic/hospital visit. Results Overall, 294 veterans’ charts were reviewed. Of these patients, 188 (63.95%) had no complication and 106 (36.05%) had a complication. Univariate analyses of social determinants are summarized in Table 1. Tobacco use was the only factor significantly associated with OPAT complication (p= 0.008). Table 1. Conclusion This analysis suggests that many social determinants thought to potentially impact OPAT outcomes, such as race/ethnicity, co-inhabitants, mental health diagnosis, employment status, and use of illicit drugs or alcohol were not significant contributions to OPAT complications in the Milwaukee VA population; although, veterans who were current smokers were more likely to have an OPAT complication. These results may speak to the VA’s integral social support provided to veterans upon discharge, and perhaps, the above social determinants should not be as heavily considered when deciding if a veteran can perform OPAT. However, it is important to consider that these results may reflect the careful selection of Milwaukee veterans discharged on OPAT, as questionable cases can be treated as an inpatient. Disclosures All Authors: No reported disclosures

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