Social determinants of health should not dictate health outcomes

By Nikia Bergan, President, GetWellNetwork.

Across the United States, persistent and growing gaps in care are creating health disparities and presenting barriers to improving overall health and health outcomes. Many health disparities stem from inherent inequalities in social determinants of health (SDOH), such as where a person lives or works, their level of education, and their access to health care.

Health equity, defined by the Robert Wood Johnson Foundation as when everyone has a fair and equal chance to be as healthy as possible, is not a new concern. For decades, health equity has been at the center of attention within the public health arena. But the COVID-19 pandemic brought the issue of health equity to the fore like never before. Something that was once discussed only among policy experts, advocates, and health communicators is now headline news, discussed at the dinner tables of Americans across the country every day.

As COVID-19 spread rapidly, it became increasingly apparent that minority patients were disproportionately affected compared to other populations. A recent study found that black people were 3.57 times more likely to die from COVID-19 than white people. The reasons are varied: multigenerational families and insufficient access to care contributed to increased infection and mortality rates in minority populations. This disparity serves as a reminder that systemic inequalities persist in many facets of American society.

Social determinants of health can be far-reaching

SDOH often presents barriers to care. Research has shown that when assessing a person’s health, their zip code is often more predictive than their genetic code. But despite its prevalence, ODS should never dictate health outcomes or the quality of care a patient receives.

SDOHs include much more than just skin color. SDOH include:

• Safe neighborhoods, transportation and housing
• Racism, discrimination and violence
• Education, job opportunities and income
• Access to nutritious food and physical fitness.
• Polluted air and water
• Language and literacy skills

While change won’t happen overnight, healthcare providers can help by making a concerted effort to make up for lost time.

How Technology Can Help Address Health Inequities

Healthcare providers must prioritize health equity and SDOH that negatively affect health outcomes. Digital health technology can help address health inequities and close the gap in care.

Integrating technology-driven patient engagement solutions into a patient’s healthcare journey is a good step in providing personalized care that can be tailored to their unique medical and social needs, but it is only a first step.

Direct and personalized communications from healthcare providers can help reduce the impact of healthcare disparities among vulnerable populations. Through artificial intelligence (AI) technology, providers can quickly coordinate a personalized care experience, enabling healthcare organizations to efficiently and effectively capture the social needs of their patients.

Addressing AI bias to ensure a more equitable future

The use of artificial intelligence and machine learning enables providers to more quickly identify areas for a specific intervention, thereby enhancing the individual patient experience while improving their overall health and well-being. Technology can help intervene by tracking and understanding the non-clinical side of the patient experience, ensuring that SDOH and other factors are taken into account for care.

However, when implementing the technology, it is critical that steps are taken to ensure that it is unbiased and that it is not repeated with biased claims. Biases can occur during development, such as when biased data sets are leveraged to build an algorithm. Bias can also occur during AI deployment.

To avoid biases in AI, algorithms must be developed with the target audience in mind, use representative data, and work as intended for the audience. Otherwise, technology that is meant to level the playing field may inadvertently drive inequalities further.

Advocating for healthcare technology

Using digital health technology that also incorporates the human aspect of healthcare can help address the systemic challenges patients face, bringing healthcare providers one step closer to creating a more equitable system for all. The work is just beginning and must continue with determination and urgency.

Health jobs