1. Who are the healthy people in America, really?
There is a relationship between poverty and health over a lifetime.
The length of your life, and quality of your life, are correlated with living conditions in which you were born, grew up, worked, and have aged.
2. What are SOCIAL DETERMINATES of HEALTH ?
Social Determinates of Health
(SDoH) are factors which align to life duration and quality of life.
The Center for Disease Control acknowledges this framework of factors.
“The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries. ” from the World Health Organization (WHO)
Clinical medical health care influences only 10 to 20% of health outcomes. Neighborhood and built environment, health and health care, social and community context, education, and economic stability are the full package of factors. HealthyPeople.gov
3. Where are Social Determinates of Health most impactful?
Research suggests impact is most severe in countries with the widest poverty / wealth gaps.
LIke America. We have a really wide gap between the haves and the have nots; we have been talking 1% and the disappearance of the middle class for 10 years. This is us.
4. When are Social Determinates of Health important?
Social Determinates of Health are important when we think about the true cost of health care, over time. Not just today, but what happened 50 years ago that got us here, and what will happen in 30 years. This long view is how we understand health care in larger trend of aging.
We don’t just have more boomers, we have more people of all ages now. So whatever health care problems we have today, we have them for a while; we can’t count on the boomers to die and take our problems to their grave.
People who graduate high school have a longer life and better quality of living in that lifetime (less sickness, less visits to the doctor, less $$ spent).
People who do not graduate high school have a shorter life and/or lower quality of living in that lifetime. (more sickness, earlier death, more visits to emergency room).
So think about that. Kids who are not finishing high school right now, will be unhealthy and expensive in 2050.
5. Why does this matter to me?
If you care about everyone being as healthy as possible, then you care about programs beyond medical care that improve health.
Maybe you are a heartless non contributor to society, so you this this matters NOT to you.
If I tell you that the children’s hospital emergency room keeps sandwiches because so many hungry kids come in, do you wince and complain that isn’t their job? Who pays for those sandwiches? you ask. How dare this hospital redirected resources from health care to sandwiches? you stomp.
if that’s you, then imagine you work at that hospital. Can you look a kid in the face and not give him a sandwich if he asked? He looks hungry.
Now if that didn’t get you, imagine that your little brother is lost, confused and needs a sandwich.
If we want more people to be healthier, then we need to look at health beyond medicine, and over a much larger time horizon. This kid who needs a sandwich in the emergency room is going to impact the world economy that YOUR kid grows up in.
We sow our seeds of health in the first 25% of our lifetime. What would it be like if health care had that lense in planning programs to reduce future cost?
More sick Americans is a bad thing for all of us. Because altruism. But also when we all end up paying $1trillion dollars in health care it has to come from somewhere. The system experiences impact, which impacts you, no matter how rich you are.
We need more local programs that support our health beyond medical care, and we need continued support of the government to grow these programs over time. Two examples of services subsidized by Medicaid that improve quality and/or length of life are:
Project Angelheart – providing medically tailor meals for Coloradoans with Life Threatening illness.
Blue Cross and Blue Shield has partnered with Lyft to provide transportation to doctor’s appointments in areas where there are no options.
Support your local programs!