The Rising Importance of Social Determinants of Health Post-COVID-19 » in-Training, the peer-reviewed online publication for medical students

Social determinants of health (SDOH) have recently received increasing recognition. The term encompasses the circumstances in which people live, including factors such as income, race, diet, housing, transportation, and environmental conditions. These factors are recognized as most important determinants of health as they can greatly influence a patient’s risk of disease and ability to seek treatment.

Actions to combat SDOH can facilitate disease prevention and improve outcomes while reducing the deep social divides in our country. Unfortunately, the COVID-19 pandemic has only exacerbated existing SDOH injustices and exposed their true impact on society. While the infection has been called the “great leveler” as it can cause disease or bring daily life to a standstill for anyone regardless of social status, we’ve seen more devastating effects in marginalized communities. Hospital admissions and mortality were significantly worse in communities with inadequate living and working conditions, less access to health care, and less social or financial capital to invest in protection. Similarly, communities of color have experienced significantly higher rates of infection and death due to a variety of factors.

Sub-optimal social circumstances can make it difficult to follow medical or public health advice. It may be more difficult to afford prescribed medications or to eat healthier. Likewise, it can be difficult to comply with quarantine restrictions when one’s home doesn’t allow for separation or when staying home from work is not an option. Such conditions can also increase exposure to unhealthy environments.

These patterns are easy to explain. Poorer air quality in marginalized areas can exacerbate respiratory symptoms, while inadequate diet or exercise can lead to the development of comorbidities. food deserts – Communities lacking access to nutritious options and fresh food – have consistent trackedit other communities in health outcomes. Poor occupational safety and health, as well as certain types of jobs – often in the service sector – held by low-wage workers can increase the risk of virus transmission due to more frequent human contact. Finally, a lack of quality education could affect the ability to easily access public health information or adhere to treatment and vaccination recommendations.

With the pandemic Millions lost their jobs and social protection systems. The brunt of these job losses was worn largely by working-class individualswhose tasks could not easily be transferred to teleworking or were no longer necessary as people stayed at home. Education has also been disrupted, as evidenced by numerous studies inferior quality of virtual instruction. The deficiencies of virtual learning could disproportionately affect underserved students who may lack a reliable internet connection or a home environment conducive to learning. These changes could have a cascading effect, worsening health outcomes for years to come.

We’ve already seen the impact of SDOH on immediate results. However, we have yet to see the long-term effects of the pandemic. Therefore, we have the opportunity to avoid this damage. Addressing inequalities is certainly a moral imperative and we must always work hard to reduce inequalities. But this is not only a moral question, but also a concrete one. The pandemic has shown us that inequality can harm all members of the community and has made it clear that no one is safe until everyone is protected.

As we emerge from the pandemic, we must continue to invest in reducing inequalities to improve the health of all communities. By improving social support systems, including affordable health insurance, fair wages and affordable housing, we can increase access to health care and preventive medicine while reducing the risk of disease from environmental factors. These measures have been They have been shown to reduce costs over the long term while improving overall well-being. Investments in the education of future generations are just as important. Education can uplift society as a whole, potentially enabling more people to find safer jobs, lead better quality lives and create healthier environments. Aside from that, An educated public may be more receptive to health advice from experts.

Educating medical trainees about SDOH is also vital to raising awareness of social needs and equipping future physicians with the tools to act as patient advocates. Medical students are in an excellent position to contribute to the medical team by assessing social needs and incorporating them into care. Hopefully, in the future, doctors will approach patients’ needs holistically, better addressing their social needs in addition to prescribing medications or performing procedures.

This would ultimately improve the patient-provider partnership and promote a healthier lifestyle while hopefully reducing avoidable readmissions. Finally, we must continue to address structural racism, as race should not be a barrier to accessing equal care. Structural racism allows multiple economic and social factors to cumulatively prevent underserved communities from leading healthy lives and seeking necessary treatments. This can reinforce existing barriers within communities.

Overall, deterioration in SDOH during the pandemic is likely to have cross-generational effects. Unfortunately the Pandemic has pushed millions further into poverty. This makes it likely that even more people will face SDOH-related inequalities should new post-COVID-19 health threats emerge. By addressing this issue, we can reduce the damage of a future pandemic while improving outcomes for routine health conditions and reducing healthcare costs.


COVID Chronicles

The COVID-19 pandemic has presented our community with an enormous challenge – certainly from a health perspective, but also in almost every other aspect of daily life. Our daily routines have been turned upside down – from the way we work, play, learn, socialize and travel. Countless times the unimaginable has happened and it is safe to say that we will never see the world the same way again. As future physicians, it is important that we recognize the challenges healthcare faces during the pandemic and, perhaps more importantly, the never-ending changes that our future medical students, physicians, and patients will face. This column examines the myriad obstacles we’ve overcome and their enduring impact, along with emerging trends we’ll see in healthcare for years to come.

Yash Shah (5 posts)

Columnist and editor for medical students

Sidney Kimmel Medical College at Thomas Jefferson University

Yash attends Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA. He was pursuing a Bachelor of Science degree in Premedicine from Penn State University. Prior to medical school, Yash worked in clinical and translational oncology research at the Children’s Hospital of Philadelphia. He has a long-standing interest in contributing to medical education, advancing public health policy and working with cancer patients. In his spare time he enjoys playing tennis, cheering for the Eagles, reading and travelling.

COVID Chronicles

The COVID-19 pandemic has presented our community with an enormous challenge – certainly from a health perspective, but also in almost every other aspect of daily life. Our daily routines have been turned upside down – from the way we work, play, learn, socialize and travel. Countless times the unimaginable has happened and it is safe to say that we will never see the world the same way again. As future physicians, it is important that we recognize the challenges healthcare faces during the pandemic and, perhaps more importantly, the never-ending changes that our future medical students, physicians, and patients will face. This column examines the myriad obstacles we’ve overcome and their enduring impact, along with emerging trends we’ll see in healthcare for years to come.

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