One of the greatest aspects of being a doctor that virtually all premedical students look forward to is the opportunity to work closely with patients, using one’s knowledge of medical science to treat or manage disease.
Yet beyond the confines of the hospital or clinic, where most of this work occurs, a multitude of outside factors directly affect the chances of someone getting ill, the likelihood that he or she will receive treatment and the odds that the treatment will work.
These factors, which are predominantly socioeconomic in nature, have been around for centuries but have come to light further in the wake of the COVID-19 pandemic. There is evidence that people with lower education levels, those from poorer households, those living in suboptimal housing conditions and immigrants who face language barriers are more likely to get infected with COVID-19 or die from it.
A similar phenomenon is observed for racial and ethnic minority groups.
These external factors — collectively referred to as the social determinants of health, or SDH — can influence health outcomes for almost every patient that you will encounter in medical school and beyond. As a result, understanding SDH and recognizing their impact on your future patients is important.
What Are Social Determinants of Health?
According to the World Health Organization website, social determinants of health are “non-medical factors that influence health outcomes” and “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” Some examples are education level, socioeconomic status, income and housing.
[Read: Why Premeds Should Engage in Health Policy, Advocacy.]
Your family’s income level, for example, is likely to influence where you live and can affect your health. A study published in 2010 in Health Affairs journal showed that children from poor households who grew up in neighborhoods with few parks, recreation centers or sidewalks were more likely to be obese or overweight.
Education is another example of an SDH that affects health and well-being. A study published in 2006 in the American Journal of Public Health showed that adults with less education than a high school diploma were more likely to be diagnosed with diabetes than those who had obtained a bachelor’s degree.
The mechanisms by which social determinants can affect health outcomes are not fully understood and are the subject of research investigations. What is clear is the profound role they play in health outcomes: As much as 55% of health outcomes can be determined by SDH, according to the WHO.
Why Premeds Should Understand SDH
Premeds should strive to learn about SDH for several reasons. Understanding the social circumstances of a patient’s life will help you provide more tailored care for that patient and, as a future physician, be more empathetic toward patients’ circumstances.
Some may be inclined to judge a patient for making poor health choices, like not exercising or eating unhealthy. But if doctors understood that there are external factors — many of which are beyond the patient’s control — that lead to such choices, we would be more inclined to support patients in overcoming these barriers.
[READ: U.S. Health Care System Challenges: What Every Premed Student Should Know.]
An interesting study conducted in Boston and published in Pediatrics journal in 2015 found that at pediatric clinics where information was gathered about SDH, health care providers offered support by linking families with social services, leading to improved social and economic situations for those families.
It should come as no surprise that med schools are impressed by applicants who show an awareness of SDH. To med schools, such awareness not only makes you better prepared to become a doctor but also demonstrates that you have a mature understanding of your limits as a future health care provider.
How to Learn About SDH
Premed students can expand their knowledge of SDH through many avenues, including coursework at their university or books and articles about the topic. This should be supplemented with experiences in the real world that can help you better appreciate the social obstacles that some patients face daily.
Volunteering with organizations that provide social support to communities in need is a great way to understand some of the challenges that affect patients in their daily lives.
One former student volunteered with a nonprofit organization that helped families access healthy foods at affordable prices. This experience gave her a solid understanding of the many ways in which large segments of the population face difficulty accessing healthy nutrition and the myriad adverse health consequences.
[Read: Volunteer Activities for Premed Students During Coronavirus Outbreak.]
Volunteer work in clinical settings, particularly involving low-income patient populations, is also a great way to learn more about the impact of SDH on patients. If you find patients who are willing to speak with you, sit down with them and listen to their life stories. Try to identify factors that may have made it difficult for them to receive the medical care they need.
How to Discuss SDH in Medical School Applications
One mistake med school applicants make is assuming that as future physicians, they could single-handedly alleviate the many nonmedical barriers that hinder a patient’s ability to achieve good health. This assumption is naïve, as many of these factors are complex and have deep systemic causes. You will come across more informed in your med school applications if you acknowledge the complex nature of these issues.
During interviews or in your essays, aim to show medical schools that as you expand your knowledge of medicine throughout your training and beyond, you will strive to build on your knowledge of SDH to provide better care to your future patients.
It also looks great if you show med schools that you aspire to address some of these challenges and that you recognize that they require collaborative team efforts and long-term commitment.
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Social Determinants of Health: What Premeds Should Know originally appeared on usnews.com
