The Socioeconomic Impact Of The Social Drivers Of Health

Dr. Adam Tabriz

Addressing Social Drivers of Health Or Epitome Of A double-Edged Sword For Patients And Physicians Alike — Or Is IT?!

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Photo by Bruno Nascimento on Unsplash

Social Drivers of Health or SDOH(also called Social Determinants of Health) have gained significant attention in the past decade by healthcare leaders around the globe because SDOH determines up to 80% of our health outcomes.

Where we live, what are our financial circumstances, if we have access to affordable, healthy foods, and other non-medical factors influence our health and wellness.

Social drivers of health care comprise conditions in the places where people live, learn, work, and play, like access to clean water, medical care, access to education, and a healthy workplace.

Social Drivers of Health are not the sole factors that affect our health. In contrast, Individual Determinants of Health (IDOH) like biological and genetic, age, sex, family history, and Behaviors such as diet, exercise, and tobacco use are also important. However, here I would like to focus my discussion solely on the SDOH.

Addressing Social Drivers Of Health Is vital To Public Health.

Today, we live through an era when all the necessary amenities are available but hardly ever accessible to all citizens. overcoming this obstacle where every individual has a fair chance of achieving their fullest health potential is called "Health Equity."

The modern healthcare infrastructure ought to address social and individual drivers of health to ensure health equity. But unfortunately, fulfilling such tasks by the health leaders is placing a growing administrative burden on the physician community.

In February 2022 Physicians Foundation conducted a physician survey examining how the Social Drivers of Health Affect the Nation's Physicians and their Patients. The survey is part one of the three surveys designed by the foundation.

In the survey collected between February 3 through 11, 2022, 1,502 physicians indicated that patients' health outcomes are affected by at least one SDOH. The survey did not suggest any significant variation in the answers based on the specialty.

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Adapted from: The Physicians Foundation 2022 Physician Survey: Part 1

Physicians, despite knowing that there is a significant need to address the social drivers of health, nonetheless, 61% feel they do not have enough time and ability to handle their patients' SDOH virtually. Not surprisingly enough, an even higher number of physicians (87%) expressed the need for more significant time and ability in the future. Eighty-nine percent (89%) attributed the problem to the limited time during patient visits. Eighty-four percent (84%) believe insufficient workforce to steer patients to community resources contributed to their administrative burden.

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Adapted from: The Physicians Foundation 2022 Physician Survey: Part 1

Eight out of 10 physicians believe that addressing patients' social drivers of health contributes to their burnout rates, where Six out of 10 (63%) feel burnout when trying to complete SDOH tasks.

We have identified multiple policy measures in the recent decade being consequential to improving the health outcomes of the patients and ensuring high-quality, cost-efficient care across the board. Those identified by the survey as:
• Reimbursing physician-directed efforts to address SDOH — 86%
• Incentivizing payors to invest in the availability and quality of community resources to address patients' SDOH — 84%
•Providing greater flexibility for Medicare Advantage to reimburse for
addressing SDOH — 84%
• Integrating SDOH into payment policy — 75%

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Adapted from: The Physicians Foundation 2022 Physician Survey: Part 1

Addressing Social Drivers of Health Is An Extra Workload And Can Be Costly.

Some healthcare leaders and bureaucrats recon addressing the Social determinants of health are as straightforward as mandating physicians and incentivizing them to complete those tasks. As we experience today, such an approach is a double-edged sword without balancing the "quality, time, and cost" of such an injunction.

As the survey suggests, the burden of achieving quality will fall on time and cost. And since physicians persistently feel pressured for the time during the patient visit to maintain the quality health leaders are looking for, that leaves no leeway but rising healthcare costs. Consequently, directly or indirectly, higher healthcare costs will fall on the patients and taxpayers in the case of government-run healthcare programs.

Let us not forget that collecting Social Drivers of Health is nothing short of a data collection task. Healthcare Costs are subject to increase due to addressing SDOH if we cling to the orthodox model of health care delivery. Thus, amidst "value-based physician reimbursement" reform, it risks physician burnout.

Physician time and clinical skills are valuable, and the system should not squander overzealous administrative tasks and data collection assignments.

We have no choice but to address the SDOH and IDOH if we intend to establish health equity, but not necessarily at the expense of physicians and to ensure a healthy life for our patients. Nonetheless, tackling social drivers of health in the face of merit-based physician reimbursement necessitates an infrastructural revolution.

Social drivers of health undertaking invariably call for an approach that doesn't solely lean on human intervention. Instead, "physicians' administrative tasks operations" should sustainably utilize automation with caution and transparency.

Furthermore, the modern healthcare infrastructure demands cyber connectivity and interoperability that mold into the concurrently evolving workflow automation and the human elements. That is the footing for independent collaboration beyond jeopardizing its contributors' respective privacy and intellectual investments.

Modern Healthcare Demands A Hybrid Cyber-Physical Human System

A system that ensures patients receive the care they deserve irrespective of their socioeconomic, logistics, and geographic status at a fair value (direct or indirect) without increasing the burden on the physicians. That is a connected system of computers, medical devices, and people "communicating" across cyberspace and time while allowing others, devices, and data streams to join and disjoin.

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Adam Tabriz is a Physician, Writer, Entrepreneur, and public health policy, expert. He is an advocate for Personal liberty. The combination of his experience and expertise underlines his passion for advocating true “Personalized Healthcare” and “Healthcare without Borders.” His favorite slogan is: “Peace of mind would come to all people through the universal respect for the basic human rights of everyone”

San Francisco, CA
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