The social determinants of health: Too long neglected as drivers of health outcomes

A watershed change in healthcare documentation occurred on January 1, 2021. For the first time in 24 years, the Center for Medicare and Medicaid Services (CMMS) created the opportunity to recognize and get paid for documenting the presence of health disparities into the national healthcare billing system.

Specifically, the acknowledgement of “diagnosis or treatment significantly limited by social determinants of health” is now official!

What are the social determinants of health? The Centers for Disease Control and Prevention (CDC) definition of the social determinants of health (SDoH) is “life enhancing resources, such as food supply, housing, economic and social relationships, transportation, education, and health care whose distribution across populations effectively determines length and quality of life.”  The addition of SDoH into the payment revisions for 2021 can have a big impact on the health of specific population groups, disease management and every person’s well- being. A  zip code’s influence on the health of those living there is multifold.

Where you live directly affects your health in a number of ways, from exposure to air pollution and toxins to accessibility of healthy  food, green space and medical care.

I have practiced family medicine in my community for 34 years and yet I never specifically inquired of my patients about these daily life circumstances. I was too focused on following the traditional standards of care for managing chronic diseases and entirely missing and ignoring causes and aggravating factors. In other words: “missing the forest for the trees.”

Not only do we have much of the data already, from organizations like DataHaven, we can easily and quickly collect it from individuals seen in any medical setting, if only all healthcare organizations would make the effort. Collecting the data is step 1 and acting on identified needs is step 2.

The social determinants of health: Too long neglected as drivers of health outcomes, Howard Selinger M.D., CTMirror, Mar. 19, 2021, available here

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