scholarly journals The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis

2021 ◽  
Vol 18 (2) ◽  
pp. 792
Author(s):  
Emily L. Silverberg ◽  
Trevor W. Sterling ◽  
Tyler H. Williams ◽  
Grettel Castro ◽  
Pura Rodriguez de la Vega ◽  
...  
Keyword(s):  
High School ◽  
Health Care ◽  
Diabetic Retinopathy ◽  
Social Determinants Of Health ◽  
Health Care Providers ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Outcome Variable ◽  
Diabetic Patients ◽  
Care Providers

One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14–3.90), out of work (OR 2.82; 95% CI: 1.62–4.92), unable to work (OR 2.14; 95% CI: 1.57–2.91), did not graduate high school (OR 1.91; 95% CI: 1.30–2.79), only graduated high school (OR 1.43; 95% CI 1.08–1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09–1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients.

Facing the Need: Screening Practices for the Social Determinants of Health

2017 ◽  
Vol 45 (3) ◽  
pp. 431-441 ◽  
Author(s):  
Joanna Theiss ◽  
Marsha Regenstein
Keyword(s):  
Health Care ◽  
Social Determinants Of Health ◽  
Health Care Providers ◽  
Social Determinants ◽  
Qualitative Interviews ◽  
Determinants Of Health ◽  
Care Providers ◽  
Screening Practices ◽  
The Social ◽  
Care Approach

Despite evidence that social factors can result in poor health outcomes, and the emergence of payment models that encourage the use non-medical interventions to improve health, many health care providers do not identify the social determinants of health within patient populations through routine screening. This Article explores the possible reasons for this inconsistency by considering screening practices in medical-legal partnerships (MLPs), the health care approach most concerned with identifying and treating the social determinants of health. Through an analysis of the results of a national survey and qualitative interviews with MLPs, we discovered that screening is not operationalized or consistent within many MLPs. We conclude that although health care providers may recognize the value of screening, they are not yet embracing the practice, perhaps because of an unspoken fear that fulsome screening identifies so many unmet social and legal needs that community-based resources cannot satisfy demand. This fear is unfounded. Approaches such as MLP demonstrate that social and legal needs can be efficiently treated through collaboration with other professionals, often within the health care setting. Nevertheless, providers must first operationalize screening to truly understand the scope of the need in their patient populations and collaborate to address those needs.

scholarly journals The Lived Experience of Syrian Refugees in Canada: A Phenomenological Study

2021 ◽  
Author(s):  
Khaldoun Aldiabat ◽  
Enam Alsrayheen ◽  
Catherine Aquino-Russell ◽  
Michael Clinton ◽  
Roger Russell
Keyword(s):  
Health Care ◽  
Social Determinants Of Health ◽  
Health Care Providers ◽  
Social Determinants ◽  
Lived Experiences ◽  
Phenomenological Study ◽  
Determinants Of Health ◽  
Syrian Refugees ◽  
Care Providers ◽  
The Social

Health care providers in Canada are expected to take care of people from a variety of cultural backgrounds, and it is difficult for health care providers to deeply understand the lived experiences of some individuals to provide them with culturally sensitive care. Syrian refugees comprise one such group of newcomers to Canada. This phenomenological study aimed to uncover the meaning of the lived experiences of Syrian refugees using Giorgi’s (2009) method. Seven participants’ descriptions were viewed through the lens of the social determinants of health model. Seven essences of the general structural description or the meaning Syrian refugees gave to their experiences of living in Canada were synthesized. Syrian refugees live paradoxical experiences that are both rewarding and less rewarding when viewed through the lens of the social determinants of health (social support, environment, culture, education, health services, employment, and income). These experiences have influenced their health in both positive and negative ways. This study highlights the need for more culturally sensitive health care interventions and assistance for Syrian refugees/newcomers in Canada. As a next step, an action research study involving Syrian refugees as co-researchers may help address the social determinant of health risks in this population.

Storytelling to Capture the Health Care Perspective of People Who Are Homeless

2019 ◽  
Vol 30 (2) ◽  
pp. 182-195
Author(s):  
Margaret Moore-Nadler ◽  
Clista Clanton ◽  
Linda Roussel
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Social Determinants Of Health ◽  
Health Care Providers ◽  
Social Determinants ◽  
Care Providers ◽  
Philosophical Approach ◽  
Key Concepts ◽  
Compromised Systems ◽  
The Voice

Utilizing a hermeneutic philosophical approach, the researchers explored the perceptions and experiences of people who are homeless in Mobile, Alabama, receiving health care and interacting with health care providers. Using the voice of the participants, discussions among the researchers, and supporting literature reinforcing key concepts, a framework was created illustrating the lived experience. The following themes were identified: social determinants of health, compromised systems, professionalism, dehumanization, engagement, and downward trajectory. The experiences described and themes identified indicate a breakdown in therapeutic relationships between homeless individuals and health care providers, contributing to the continuing destabilization common in this population.

scholarly journals Assessing Physical Activity Behavior of Cancer Survivors by Race and Social Determinants of Health

2019 ◽  
Vol 40 (1) ◽  
pp. 7-16
Author(s):  
Matthew Asare ◽  
Scott McIntosh ◽  
Eva Culakova ◽  
Amina Alio ◽  
M. Renee Umstattd Meyer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Cancer Survivors ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Access To Health Care ◽  
Determinants Of Health ◽  
Outcome Variable ◽  
Economic Stability ◽  
Access To Health

Introduction Black cancer survivors remain at a higher risk for secondary cancers, cancer recurrence, and comorbid conditions than non-Hispanic White survivors. Physical activity may help improve health outcomes and overall quality of life. We assessed cancer survivors’ physical activity by race/ethnicity and the effect of social determinants of health (SDH) constructs (i.e., economic stability, education, and access to health care) on physical activity. Methods This was a cross-sectional analysis of data from the 2016 Behavioral Risk Factor Surveillance System. The outcome variable was physical activity after cancer diagnosis and the predictor variables were SDH and race. Multivariable logistic regressions were used to examine associations between race and physical activity and the effect of SDH on physical activity. Results Among 3,787 cancer survivors, 91.6% self-identified as White and 8.4% as Black. Blacks were more likely than Whites to report low economic stability, low access to health care, and low health literacy (all ps < .01). Blacks were less likely than Whites to engage in physical activity after controlling for demographic and clinical factors (adjusted odds ratio [ORAdj] = 0.71; 95% confidence interval [CI] = 0.56–0.91; p = .01) and after additional adjustment of SDH (ORAdj = 0.77; 95% CI = 0.60–0.99; p = .04). Conclusions The findings suggest that though Black cancer survivors are less than White to engage in physical activity, and SDH partially explained the racial difference in physical activity behaviors. These findings highlight the need to address barriers to health-care access, economic stability, and educational attainment.

scholarly journals Impact of COVID-19 on social determinants of health for adults with cystic fibrosis

2021 ◽  
Vol 15 ◽  
pp. 175346662110374
Author(s):  
Dana Albon ◽  
Heather Bruschwein ◽  
Morgan Soper ◽  
Rhonda List ◽  
Deirdre Jennings ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Issues ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Health Questionnaire ◽  
Improvement Project ◽  
The Impact

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

scholarly journals Social determinants of health in mental health care and research: a case for greater inclusion

2019 ◽  
Vol 26 (8-9) ◽  
pp. 895-899 ◽  
Author(s):  
Joseph J Deferio ◽  
Scott Breitinger ◽  
Dhruv Khullar ◽  
Amit Sheth ◽  
Jyotishman Pathak
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Social Determinants Of Health ◽  
Language Processing ◽  
Social Determinants ◽  
Ad Hoc ◽  
Extraction Methods ◽  
Determinants Of Health ◽  
Independent Risk Factors

Abstract Social determinants of health (SDOH) are known to influence mental health outcomes, which are independent risk factors for poor health status and physical illness. Currently, however, existing SDOH data collection methods are ad hoc and inadequate, and SDOH data are not systematically included in clinical research or used to inform patient care. Social contextual data are rarely captured prospectively in a structured and comprehensive manner, leaving large knowledge gaps. Extraction methods are now being developed to facilitate the collection, standardization, and integration of SDOH data into electronic health records. If successful, these efforts may have implications for health equity, such as reducing disparities in access and outcomes. Broader use of surveys, natural language processing, and machine learning methods to harness SDOH may help researchers and clinical teams reduce barriers to mental health care.

scholarly journals Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Matthew W. Kreuter ◽  
Tess Thompson ◽  
Amy McQueen ◽  
Rachel Garg
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Determinants Of Health ◽  
Social Services ◽  
Social Determinants ◽  
Safety Net ◽  
Social Needs ◽  
Determinants Of Health ◽  
Health Improvement ◽  
Health Care Settings

There has been an explosion of interest in addressing social needs in health care settings. Some efforts, such as screening patients for social needs and connecting them to needed social services, are already in widespread practice. These and other major investments from the health care sector hint at the potential for new multisector collaborations to address social determinants of health and individual social needs. This article discusses the rapidly growing body of research describing the links between social needs and health and the impact of social needs interventions on health improvement, utilization, and costs. We also identify gaps in the knowledge base and implementation challenges to be overcome. We conclude that complementary partnerships among the health care, public health, and social services sectors can build on current momentum to strengthen social safety net policies, modernize social services, and reshape resource allocation to address social determinants of health. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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