Tackling social factors that impact health – GWC Mag

If you made a list of actions that lead to a healthy life, it would probably include eating the right foods, exercising regularly and getting plenty of sleep each night.

But the factors that determine your health actually go beyond simple dos and don’ts. For many people, non-medical factors that are out of their control make healthy living more difficult.

Social drivers of health

These factors are called social drivers (or determinants) of health. The U.S. Department of Health & Human Services defines them as “conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.”

They include:

• Access to education, food, housing and transportation
• Financial resource strain
• Social connections to family, friends and other acquaintances
• Physical activity
• Safety and domestic violence
• Stress
• Depression, including postpartum
• Alcohol and tobacco use

Statistics show that 60%-80% of an individual’s health outcomes are determined by these drivers. And according to the latest U.S. census, 10%-22% of Americans are negatively impacted by them.

“It wasn’t until recently that these factors were considered part of health care providers’ area of responsibility,” said Sarah Stewart de Ramirez, MD, medical director of Population Health Services at OSF HealthCare. “But we started to see a shift with the implementation of the Affordable Care Act as there was recognition that more needed to be done to keep folks healthy. It started to shift focus outside doctors’ offices into the communities where people live.”

Asking the right questions

In 2017, OSF HealthCare began studying ways to screen patients for social drivers of health. And in 2019, the Ministry first implemented screening measures at OSF Medical Group – Primary Care clinics. At these locations, patients are asked to take a few minutes to answer questions on a tablet to identify social factors they’re facing. OSF then connects them to helpful resources.

These screenings have included questions like:

In the past year …

• Have you been unable to pay for utilities when they were really needed?
• Have you found that the food you bought just didn’t last and you didn’t have money to get more?
• Has lack of transportation kept you from medical appointments or from getting medications?

“And now, we’re expanding our efforts and working to offer a standard screening process and questions in all areas of OSF that have contact with patients,” said Brandi Clark, vice president of Digital Care at OSF HealthCare. “This includes hospitals and doctors’ offices as well as all of our OSF OnCall digital program offerings.”

OSF is also working to create additional partnerships with community organizations to develop solutions for social drivers of health most prevalent in given areas. All of this will provide a more holistic, coordinated approach to patient care resulting in better health outcomes.

“OSF has always been focused on serving the community,” Dr. Stewart de Ramirez said. “But we’re now approaching it with the same scientific methods that we use in clinical medicine. This enables us to understand upstream factors that could be causing someone’s illness, whether that be lacking money to buy food, lacking transportation for doctor’s appointments, suffering from alcoholism or domestic violence, etc.”

Awareness driven by COVID-19

OSF was well on its way toward this approach when COVID-19 arrived in 2020. The pandemic drew national attention to social drivers of health and shined a light on health disparities and inequities they cause.

“That’s when the health care industry as a whole realized that the status quo wasn’t acceptable,” Dr. Stewart de Ramirez said. “These drivers must be measured and addressed, which allows us to truly provide whole-person care.

“This is now our standard of care just like screening for breast cancer and other illnesses. Federal and state governments and insurance companies are also requiring health systems to take action, so this isn’t a ‘nice to have’ thing or ‘icing on the cake.’ It’s front and center.”

OSF plans to launch this new approach to social drivers of health in 2024.

Last Updated: August 7, 2023