Social Determinants of Health – The Neighborhood and Built Environment

Social Determinants of Health – The Neighborhood and Built Environment

As a social determinant of health (SDOH), the neighborhood and built environment significantly influences all aspects of delivery and access to healthcare as well as population and individual health outcomes. For instance, the neighborhood and the built environment contribute to the most notable disparities in healthcare access and population health outcomes, such as hypertension (Grazuleviciene et al., 2020). The frequency of evaluating the social determinants of health with patients varies from one SDOH to another. Questioning patients to assess the neighborhood and built environment SDOH from the initial evaluation should be determined by the specific objective of focus.

For some objectives, such as physical activity and access to transportation, questions should be asked every time the patient is seen. This is because transportation barriers are linked to delayed access to medical care, affect populations across all social demographics, and can occur at any time (Wolfe et al., 2020). For physical activity, it is important to ask questions frequently to determine progress and motivate the patients to adhere to the plan. For other objectives, such as the health of the environment they live in, workplace settings and health, as well as the quality of their housing, questioning should be done at a frequency of one to three months as these take time to change. However, it is important to consider the specific factors for each patient to determine the evaluation frequency, as some people are more vulnerable than others.

There are best practices for addressing the social determinants of health. For instance, interdisciplinary collaboration that brings together medical professionals and social and community health workers can help evaluate needs at an individual level. Another best practice is the integration of EHRs, which can improve the accessibility of health information to determine high-risk populations to make decisions on resource allocation. Other practices like training and education and employing cultural competency can help individuals self-evaluate themselves at the community level. They can also help manage and support patients based on their cultural background and beliefs.

References

Grazuleviciene, R., Andrusaityte, S., Grazulevicius, T., & Dedele, A. (2020). Neighborhood social and built environment and disparities in the risk of hypertension: A cross-sectional study. International Journal of Environmental Research and Public Health, 17(20), 1–16. https://doi.org/10.3390/IJERPH17207696

Wolfe, M. K., McDonald, N. C., & Holmes, G. M. (2020). Transportation barriers to health care in the United States: Findings from the national health interview survey, 1997-2017. American Journal of Public Health, 110(6), 815–822. https://doi.org/10.2105/AJPH.2020.305579

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At what frequency do you think we should evaluate the social determinants of health with our patients? Do we ask these questions every time we see them or at certain intervals? Are there best practices for addressing the social determinants of health?