According to the Centers for Disease Control and Prevention (2022), "Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life… SDOH are one of three priority areas for Healthy People 2030, along with health equity and health literacy. Healthy People 2030 sets data-driven national objectives in five key areas of SDOH: healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. Some examples of SDOH included in Healthy People 2030 are safe housing, transportation, and neighborhoods; polluted air and water; and access to nutritious foods and physical health opportunities".
https://www.cdc.gov/about/sdoh/index.htmlLinks to an external site.
Resources
• Reflect on the concept of social determinants of health as presented in the resources.
• Contemplate whether digital inclusion or broad band access should be added to the 5 key areas of social determinants of health.
• Using the optional outside resources or other peer reviewed journal articles, consider how electronic health records, mobile health, patient portals, or telemedicine can impact and be impacted by the social determinants of health.
Post a description of your views on whether or not digital inclusion or broad band access should be added as a key area to the social determinants of health. Be specific and provide examples that support your position. Explain how electronic health records, mobile health, patient portals, or telemedicine can impact and be impacted by the social determinants of health. Support your explanation with the required or optional resources.
Respond to at least two of your colleagues on two different days using one or more of the following approaches:
• Respond to a colleague whose views differed from yours on whether digital inclusion of broad band access should be added as a key area to the social determinants of health. Expand on your colleagues' posting by providing additional insights or contrasting perspectives based on the readings.
• Respond to a colleague who discussed a different health IT system than you did. Share an insight from having read your colleagues' posting, synthesizing the readings to provide new perspectives on how the system can impact or be impacted by the social determinants of health.
Full Answer Section
Specific Examples Supporting this Position:
- Healthcare Access and Quality: The COVID-19 pandemic starkly exposed the "broadband health gap." Telemedicine, which became a lifeline for many during lockdowns and continues to offer crucial access to specialists and remote care, is impossible without stable internet. Patients without broadband cannot fully utilize telehealth services, including video visits, asynchronous messaging via patient portals, or remote monitoring devices. Even accessing information about local clinics, making appointments online, or researching health conditions becomes a significant barrier.
- Education Access and Quality: As education increasingly relies on online platforms, remote learning, and digital resources, students without broadband access are left behind. This exacerbates existing socioeconomic gaps in educational achievement, as seen during the pandemic when many students had to rely on public Wi-Fi hotspots or struggle with limited data plans to attend virtual classes or complete homework. Lack of access directly impacts a child's ability to learn and thrive, affecting their future economic stability.
- Economic Stability: In today's economy, broadband access is essential for job searches, online applications, remote work opportunities, and even filing for unemployment benefits. Individuals without internet access are at a significant disadvantage in securing and maintaining employment, further entrenching economic instability. This creates a cycle where lack of digital access contributes to poverty, which then negatively impacts health.
- Social and Community Context: Digital platforms are increasingly vital for social connection, community engagement, and accessing support networks. Lack of internet access can lead to social isolation, hindering individuals' ability to connect with family, friends, and community resources. During times of crisis, essential information and community support often disseminate online.
- Neighborhood and Built Environment: While not directly tied to physical structures, the "digital infrastructure" of a neighborhood significantly impacts its residents' ability to access services, engage in remote work, and utilize educational opportunities that are increasingly available online. Areas with poor broadband infrastructure are often those with other existing SDOH challenges, creating a compounding disadvantage.
In essence, digital inclusion and broadband access are not merely amenities; they are foundational prerequisites for effectively navigating the modern world and accessing resources that directly influence health outcomes. They are, as some have termed them, "super social determinants of health" because they underpin and amplify the impact of all other SDOH areas (AHIMA Foundation, 2022).
Impact of Health IT Systems on and by Social Determinants of Health
Electronic health records (EHRs), mobile health (mHealth), patient portals, and telemedicine are powerful tools that can both
impact and be
impacted by social determinants of health.
1. Electronic Health Records (EHRs):
- Impact on SDOH: EHRs have the potential to significantly improve health outcomes by facilitating better care coordination, reducing medical errors, and improving efficiency. When designed to capture SDOH data (e.g., housing status, food insecurity, transportation barriers, digital literacy levels), EHRs can provide a holistic view of a patient's life beyond clinical symptoms. This allows providers to identify specific social needs and make appropriate referrals to community resources, thereby addressing underlying SDOH that contribute to poor health (Journal of AHIMA, 2022). For example, an EHR flagging food insecurity for a diabetic patient can prompt a referral to a food bank, potentially improving their diet and blood sugar control.
- Impacted by SDOH: The effectiveness of EHRs can be limited by SDOH. For instance, if a patient lacks stable housing, their contact information in the EHR may become outdated, hindering follow-up. Poor education access and quality can result in low health literacy, making it difficult for patients to understand information within their records even if they have access.
2. Mobile Health (mHealth):
- Impact on SDOH: mHealth (health services and information delivered via mobile devices like smartphones and tablets) can greatly expand healthcare access, particularly for underserved populations. Apps for chronic disease management, medication reminders, or health education can empower individuals to take a more active role in their health. For instance, an mHealth app providing nutrition tips in a low-income area with limited access to healthy food options could offer creative solutions for making healthy choices with available resources. It can bridge geographical barriers for those in rural areas or with transportation challenges (ResearchGate, 2023).