Social Factors Impact Health
I think most of us would agree with the statement that if you don’t have access to adequately nutritious food your health will be negatively impacted. In a medical setting, it would seem imperative for a doctor to find out information about the patient’s social situation in an effort to get the full picture of the influential factors on the patient’s health. A 2011 survey, however, found that four out of five doctors felt they lacked the tools to help their patients with social needs. With the same survey finding that 85% of doctors report the clear connection between an individual’s unmet social needs and declining health, there appears to be a gap that needs to be filled.
One of the barriers to the implementation of a system that would more adequately address the social needs of patients such as access to good housing in safe neighborhoods, options for exercise, and access to nutritious food is the cost. Physicians have expressed concerns about reimbursement for these additional services. A system has been in place since 2003 in Minnesota that is meeting both the needs of patients and providers with the medical home model. Rishi Manchanda, MD, MPH, a practicing internist and pediatrician in Los Angeles, stated in a MedPage article regarding this model, “This is a huge deal because it’s the first time they’re requesting money to be tied to work at the intersection of clinical care and the social determinants. This is what we should be watching for, the experience of places like Minnesota and others that are using the Medicaid Health Home and a host of other regulations and policy opportunities within the Affordable Care Act to try to align the medical home concept within a built environment and do so in ways that are tied to funding.”
Take a moment to think about the social factors in your own life, and how they impact your health. If you have a safe place to live that does not contribute to health problems, either through environmental factors or increased stress levels, then you already have a social determinant in your favor. For those of us without adequate housing, the odds are stacked against us putting us at higher risk for health problems. With the additional money available to states under the Affordable Care Act, Minnesota plans to increase the funding to these medical homes further developing a model to be followed by other states.
Click here to read the MedPage article on addressing social factors in health.