What are the Social Determinants of Health?
Social determinants of health (SDoH) as defined by the World Health Organization and the Center for Disease Control (CDC) are the non-medical factors that influence health outcomes. They include the conditions in which people are born, grow, live, work and age. SDoH encompass the interrelated, complex social, economic and political systems that shape one’s living conditions.
Breaking the components of SDoH down into greater detail, we know that the aspects of one’s physical environment that impact one’s health include place of residence, transportation systems, buildings, spaces, crowding conditions, access to and quality of care, and health insurance status.
The components of one’s social environment that influence one’s health include discrimination, income, education level, and marital status.
Social determinants of health are closely correlated to one’s opportunities and one’s access to resources to protect, improve and maintain health. These factors, taken together, are mostly responsible for health inequities–the unfair and often avoidable differences in health status existing with and between human populations.
The Connection Between SDoH and Maslow’s Hierarchy of Needs
Another way of understanding SDoH, is to turn to Maslow’s theory of the Hierarchy of Needs. Abraham Maslow, an American psychologist, introduced this concept in 1943. He illustrated the concept in the form of a five-tiered pyramid representing what he believed to be the human hierarchy of basic necessities and the desire for human fulfillment.
The five tiers in the pyramid, from lower to higher, are:
- Biological and physiological needs
- Safety needs
- The need to feel loved
- The need for self-esteem
- Self actualization
Many different types of healthcare providers are committed to mental health and brain illness, including psychotherapists, psychiatrists, master-level counselors, and social workers. There are many effective therapies and medicines for addressing mental illness. Talk therapy, cognitive-behavioral therapy (CBT), and exposure therapies are some effective forms of treatment. Medications such as anti-depression drugs and anti-anxiety drugs can impact one’s brain chemistry in a positive way. It is essential to take action before an illness gets worse and becomes debilitating.
Maslow’s Hierarchy of Needs Explained
Maslow argued that human needs lower down in the pyramid must be met before an individual can even begin to care about needs higher up in the hierarchy. The pyramid becomes self-explanatory as you follow it from bottom to top. The bottom two tiers consist of Basic needs including bodily requirements such as food, water, warmth (the most basic of human survival needs) and safety needs which include protection from physical harm. The next two tiers (the 3rd and 2nd tiers) fall under the category of Psychological needs and include a sense of belonging and love, something that most humans seek in the form of companionship, family ties, or an intimate relationship. Self-esteem also falls under psychological needs and is defined by Maslow as feelings of accomplishment and respect that usually come from a sense of purpose and contribution to society and others. Finally, the top tier is the category of Self-Fulfillment needs. In this pinnacle tier, Maslow captures the human drive to achieve one’s full potential, including a person’s need for creative and intellectual activities that satisfy the human drive for self-expression and a feeling of harmony with one’s unique sense of purpose and criteria for happiness..
Social Determinants of Health and Wellbeing
When Maslow’s pyramid of needs is applied to healthcare, the result might look like this pyramid from the CDC on the factors that most impact Social Determinants of Health.
This CDC pyramid illustrates that the most impactful and sustainable interventions for improving health outcomes are found at the bottom tier of the pyramid. As healthcare organizations, communities, and societies think about what creates health, it is clear that the socioeconomic factors, the SDoH, can have the most impact. The variables of income, quality of housing and education, access and training for good jobs, and transportation can all have powerful effects on an individual’s health status.
Here at Catawba Valley Healthcare (CVH), we understand that the satisfaction of criteria lower down in the hierarchy of human needs happens when health organizations and their providers get involved not only at the personal healthcare level, but at the community level as well. CVH is fully committed to promoting awareness and engagement with the many factors that affect the health of all population groups in our community. As a 501c (3) comprehensive non-profit healthcare provider with a mission to support healthier communities by providing a wide range of whole-person healthcare that integrates physical and mental health, CVH partners with numerous other non-profits and healthcare providers in our communities to support all population groups, including those who are, or may become, vulnerable due to lace of access to healthcare. We support those who are, or may become, marginalized due to social, economic, or medical conditions. We serve people with Medicaid or Medicare, those who are uninsured and underinsured, those who are homeless, those without documentation, and those who are incarcerated or recently incarcerated. When needed, we help those we serve address non-medical issues that affect outcomes, such as housing, food security, relationships, and employment.
At Catawba Valley Healthcare we are addressing SDoH that cause disparity in healthcare outcomes across our communities. We want to serve as a healthcare model for other healthcare organizations and local and national policy makers addressing healthcare disparities. We know that addressing Social Determinants of Healthcare is critical to improving healthcare access and outcomes across our communities and the country. While most of our services are provided in Burke and Catawba counties in western North Carolina, we are part of a larger effort to impact healthcare access and outcomes across the country by serving as model of effective implementation and delivery of community-based services and involvement by offering a wide range of services. At CVH, we provide primary care, outpatient therapy, psychiatric treatment, peer support services, mobile crisis management, resident services, psychosocial rehabilitation, independent living options, skills training, and specialized case management and treatment. Visit our website cvhnc.org and learn more about our breadth of services and our efforts to promote healthcare awareness and solutions by addressing social determinants of healthcare.
Call us today at Catawba Valley Healthcare at (828) 695-5900.