Social Determinants of Health

Although there are lots of physical, tangible diseases that cause people to become ill, there is a single disease that is intangible, not quantifiable, but no less lethal. It’s called Life Sucks Disease (LSD). People commonly accept the notion that high blood pressure, high cholesterol, and diabetes can kill us. But what about all of the other social factors that surround those diseases? Stressing about finances, work, and relationships can distract us all from the critical self-care that helps prevent things like high blood pressure, high cholesterol, and diabetes (Drane, 2016). Other symptoms of LSD include: cold sweats at kid’s sports games, feeling that the weekend isn’t long enough, and the temptation to call in sick (Schaefer, 2016). Physiologically, there is a reason that on Sundays, people fear the next day: Monday (Levitin, 2015). The amygdala gets activated and releases hormones in anticipation of the loss of freedom that comes with the start of the workweek. Other symptoms that can precipitate as a result of stress include: restlessness, sweating, muscle tension, and headaches.

Physicians need to ask probing questions to get patients to disclose these social stressors so that the whole patient can be treated. There are four things physicians can do: ask the patient probing questions, acknowledge the patient’s hardships, connect with the patient, and treat the patient. Dr. Manchanda is already doing this. His upstream approach seeks to circumvent social and environmental issues before they lead to physical health problems (Manchanda, 2016). What happens outside the doctor’s office is just as critical, if not more critical, than what goes on in the office. Issues in healthcare are typically indicative of systemic failures. Patients fall through the cracks for different reasons; however, odds are a single system failure does not just impact one patient. Health plans sit opportunistically between patients and care providers. They can use case management, care coordination, and analytics to ensure patients get optimal care that’s delivered effectively.