Social Determinants of Health
What Are Modifiable Social Determinants of Health? Many social determinants of health are modifiable. Some involve health systems. For example, follow-up after a missed primary care visit might identify lack of transportation as the cause. The health system could con- nect the patient with an insurance-provided transportation service or a social service agency that provides medical transportation. Some changes require more effort from patients. For instance, improved diets, increased physical activity, smoking cessation, and other patient-managed activities can significantly improve the health of individuals with diabetes. Especially for patients with language, financial, or cultural barriers that complicate patients’ efforts to manage their health, a health system that simply recommends changes and fails to follow up will have poor outcomes.
Not all changes to social determinants of health need to be financed by the health system. The local government or a local charity may offer a subsidy program for medical transportation. Alternatively, a health system, a local government, a local school, or a local charity might develop user- friendly tools that simplify the process of booking a ride for patients or providers. Likewise, other community organizations may support programs to improve health self-management (or be encouraged to do so by the health system).
