The Impact of Social Determinants of Health and Poverty on Health Outcomes in America

Abstract

INTRODUCTION: Over the last decade, there has been a slow but steady decline in poverty rates in the United States (U.S). However, the burden of poverty is still very high among certain communities and groups in the U.S, and it poses a challenge not just to the health of those affected but to the health of the entire country. This owes majorly to socio-economic factors in the environment as well as other determinants of health. Poverty makes it more difficult for certain individuals to make healthy life choices, have access to health coverage, live in good neighborhoods, or gain the necessary skills needed through education and job security to contribute effectively to society. Understanding the various ways in which social determinants of health contextually drive health outcomes can help provide a better approach to improving health care and addressing the health gap it has created. CONCEPTUAL FRAMEWORK: A scoping review was done based on secondary data analysis. Research materials were retrieved from search engines such as PubMed, Google Scholar, and ProQuest Public Health databases, including articles, scholarly literature, and publications. The relevant keywords for literature search included ‘social determinants of health (SDOH)’, ‘negative effects of SDOH’, ‘education’, ‘housing’, ‘poverty’, ’socio-economic status’, ‘United States’, ‘America’. Inclusion criteria: Scholarly literature and articles related to the topic of interest and published between 2012 and 2022. Exclusion criteria: Scholarly literature and articles that were unrelated to SDOH, poverty and or health and those published before 2012. About 1000 articles were retrieved but only 32articles were reviewed based on the inclusion and exclusion criteria DISCUSSION: Poverty is a complex issue that impacts health outcomes because it can be viewed as both a “cause” and an “effect”. For instance, poverty can be caused by illnesses, climate change, crime, disasters, economic inequality, etc. Yet, these same issues can occur because of poverty. People faced with the multi-dimensional aspects of poverty are more prone to making poorer health choices, affecting their quality of life. Social determinants of health (SDOH) are “conditions in the social environment in which people are born, live, learn, work, and play that affect a wide range of health, functioning, and quality-of-life outcomes and risks”. (Healthy People 2030). The US Department of Health and human services (Healthy People, 2020) has grouped the social determinants of health into 5 domains which will be discussed further in this paper (See poster for SDOH determinants). Certain conditions in which individuals live their lives have an impact on health outcomes and can cause differences in health. Increased burden of disease which are more prominent in low income and impoverished communities include chronic diseases such as hypertension, diabetes, and heart disease. Mental health and substance use disorders are also common among individuals living in these communities. (Walker E.R, Druss B.G.,2017). Every individual must interact with their environment to function fully, optimally and meet their needs. However, the conditions in which people live their lives can be directly proportional to their health outcomes. CONCLUSION: Global health priorities are determined by key policymakers which means that whatever health issue they choose to tackle becomes a "global health issue". Unfortunately, the marginalized and disenfranchised who are most affected are left out of critical decision-making processes. We must all understand that no one is healthy until we are all healthy especially with the emergence of globalization, travel, trade, etc. With the direct link between health and wellness, policymakers must shift their focus and priorities to promoting wellness by tackling poverty and other determinants of health at the grassroot. Achieving zero hunger, just like solving any other health crisis, may seem like a herculean task, but it can be done if the right strategies and tactics are employed.