Healthcare Literacy 101: The Social Determinants of Health #SDOH


I don’t think sustainable is the right word for healthcare.  Healthcare will always be here one way or another.  I think relevant is a better word.  Is our healthcare system designed to have the greatest increase in population health at any given time with whatever resources we have at that time?  To be relevant, I would like to see the pendulum swing far over to education, prevention and health promotions, from where it is now hanging, in diagnosing, treating and extending. We’ve neglected populations at risk. We don’t treat those we don’t care about. We fix we don’t heal. For me, being sustainable is ultimately about being fair.
It will always be a challenge for healthcare to be efficient, there will be pressure on voters to cut taxes but not services until apathy is addressed.  An efficient healthcare produces positive results.  We currently have a health care system where programs, services, priorities are added-on.  More layers.  More duplication.  More overhead.  Money and time is spent on resources while innovative services and programs struggle for ongoing funding and programs that empower individuals and communities start but they don’t continued, wellness gets interrupted. To be efficient, effective support must be continuous.
Healthcare is a complicated system.  What should the system do?
For a universal healthcare to function it must be realistic and operate at the population level so that it gets the most for the most.  I think we have drifting from who and what those “mosts” are.
Corporate greed is creeping into health care and I’ve had enough of it. It has set the market value of lived experience at zero, and our healthcare system is shareholder-centric rather than patient-centric.
I believe there is an approach that can be the foundation of health care policy and decision making that will stop the creep.  What if the vision of healthcare became to fundamentally address the social determinants of health?
What are social determinants of health? To me, they explain how some of us are born or destined to poor health and inferior services.
According to the World Health Organization (WHO) and this is cut and paste from their website accessed on December 4, 2017.
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.
To elaborate further The Public Health Agency of Canada, again cut and paste from their website accessed on May 27, 2014 illuminates:
Key Determinants – click on links to learn more 🙂
Income and Social Status
Social Support Networks
Education and Literacy
Employment/Working Conditions
Social Environments
Physical Environments
Personal Health Practices and Coping Skills
Healthy Child Development
Biology and Genetic Endowment
Health Services
And on their website PHAC (The Public Health Agency of Canada) continues;
The challenge we face is how to use what we know about the determinants of health to:
focus our research agenda so we can increase our understanding of how the basic determinants of health influence collective and personal well-being
adopt strategies that improve health for Canadians
That’s where a population health approach comes in. In a population health approach, taking action on the complex interactions between factors that contribute to health requires:
a focus on the root causes of a problem, with evidence to support the strategy to address the problem and efforts to prevent the problem
improving aggregate health status of the whole society, while considering the special needs and vulnerabilities of sub-populations
 a focus on partnerships and intersectoral cooperation
 finding flexible and multidimensional solutions for complex problems
 public involvement and community participation
A population health approach recognizes that any analysis of the health of the population must extend beyond an assessment of traditional health status indicators like death, disease and disability. A population health approach establishes indicators related to mental and social well-being, quality of life, life satisfaction, income, employment and working conditions, education and other factors known to influence health.
I like this! I fell in love with this before and I am in love with it still. This is a good time for an emoticon.
How about we explore what is good and what is right because to me that sounds good and sounds right and sounds like something we should stick to.
Creating solutions to those challenges is a good place to start.
That’s what innovation looks like to me.

18 thoughts on “Healthcare Literacy 101: The Social Determinants of Health #SDOH

  1. All I can tell you is that the system is chewing me up and spitting me out I’ve had such a hard time with Dr they only want you if they can fix you,I had such a fight with the pain mgmt Dr over me being late and I called saying I was running behind,my health has fallen into disrepair I was in a bad car accident going on 3 yrs I am not the same person and it sucks being a patient and proactive

    Liked by 2 people

  2. Harlon, I agree we need a population health approach. Our culture of health care (in the US at least) seems to focus mainly on individual responsibility for health and disease, e.g. if you got sick, it must have been because of bad “lifestyle” choices. But so much of what makes us healthy or not is beyond our control as individuals. Thanks for a very informative post.

    Liked by 1 person

    • Thank you Lisa for taking the time to invest in this post, and I am particularly grateful that yo keyed in on what was my primary theme – that of population health. As you mentioned people often get “blamed” for their condition, where, in fact, there were a lot of variables (genetic, gender, income status, coping skills) that play a huge factor in setting the stage.
      I am so glad I have you on my side. 🙂 Harlon

      Liked by 1 person

  3. Well said Harlon. Its sad to see a system set up with the best intentions begin to fall apart due to profit and greed. Treatments are much more profitable than prevention. There’s a shift that needs to happen – back to community, and the good of all. 💛

    Liked by 1 person

  4. According to the World Health Organization, Canada ranks #12 of 191 countries. Pray to Dhanvantari (hindu, physician of the gods and god of Ayurvedic medicine) seeking his blessings that you were not born a citizen of Sierra Leone… gurl. 🙂

    Liked by 1 person

    • Agreed, and in Canada, where we allegedly have Universal Health Care, I believe the pharmaceutical companies and other profit seeking stakeholders are taking up the lion’s share of the budget, so that we do not have the resources for effective health care delivery. It’s a mess!


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