Description |
Social determinates of health (SDoH) (Appendix A) are defined by the World Health Organization (2017) as conditions that people are born, grow, live, work, and age in (Fink-Samnick, 2018a). Individuals that are affected by SDoH are the most vulnerable in society, incurring 50% of the health care cost for only 5% of the population (Fink-Samnick, 2018a). Social determinants of health can impact population health, medication adherence, readmission rates to the hospital, treatment adherence, and cost of care (Fink-Samnick, 2018a). Fink-Samnick (2018a) stated that premature death is caused by individual behavioral factors (40%), individual genetic and genetic illness (30%), and social and environmental factors (20%). According to Powell (2019), the social and environmental factors such as safety (livingalone or having access to affordable housing), public safety (abuse or violence), local emergency or health services (access to health care), transportation (health services, food, and prescriptions)are the most significant factors negatively impacting patients' healthcare outcomes. Certain SDoH factors such as social interactions (living alone, being isolated, or lacking social support), and environment (access to food and clean environments without any toxins) can cause premature death (Fink-Samnick, 2018a). Luther and colleagues (2019a) reported that Medicare patient readmission to the hospital was related more to where they live than to their illness.According to Healthy People 2017, another SDoH factor is economic stability (poverty), education (those with higher education are more likely to live in higher economic and social circumstances), health and healthcare (access to health, primary care, and health literacy) (Fink-Samnick, 2018a). Other SDoH factors are neighborhood and environment (quality of housing, access to healthy foods, and crime), social and community (incarceration, civic participation, discrimination, and social cohesion) (Fink-Samnick, 2018a). The lack of the interdisciplinary team understanding of the patient's SDoH risks can affect the discharge planning process and increase readmissions to the hospital ( Fink-Samnick, 2018a). Lack of knowledge of the patient's needs before discharge can, in turn, affect safe, appropriate, and timely discharge from the hospital. Previous research has provided evidence that not identifying patients with SDoH risks can lead to poor patient outcomes due to inadequate discharge planning and early interventions resulting in unsafe, inappropriate, and untimely discharges from the hospital (Fink-Samnick, 2018a). There is a need for improved interdisciplinary team communication of patients with SDoH risks to improve team coordination about patients' care needs before discharge from the hospital. |