Social Determinants of Health Shouldn’t Dictate Health Outcomes

Nikia Bergan Headshot
Nikia Bergan

By Nikia Bergan, president, GetWellNetwork.

Across the United States, persistent and growing gaps in care are driving health disparities and presenting barriers to improving overall health and health outcomes. Many health disparities stem from inherent inequalities in social determinants of health (SDOH), such as where a person lives or works, their education level, and their access to healthcare.

Health equity — defined by the Robert Wood Johnson Foundation as when everyone has a fair and just opportunity to be as healthy as possible — is not a new concern. For decades,  health equity has been in the spotlight within the public health realm. But the COVID-19 pandemic brought the topic of health equity to the forefront like never before. Something once discussed only among policy experts, advocates, and health communicators is now mainstream news and discussed around the dinner tables of Americans across the nation every single day.

As COVID-19 quickly spread, it became increasingly apparent that minority  patients were disproportionately affected compared to other populations. A recent study found that Black people were 3.57 times more likely to die from COVID-19 than white people. The reasons are varied: Multigenerational families and insufficient access to care contributed to higher infection and mortality rates for minority populations. This disparity serves as a reminder that systemic inequalities persist across many facets of American society.

Social determinants of health can be far reaching

SDOH often present barriers to care. Research has shown that when assessing a person’s health, their ZIP code is often more predictive than their genetic code. But despite their prevalence, SDOH should never dictate health outcomes or the quality of care a patient receives.

SDOH include far more than just skin color. SDOH include:

While change will not happen overnight, healthcare providers can help by making a concerted effort to make up for lost time.

How technology can help address health inequities

Healthcare providers must prioritize health equity and the SDOH that negatively affect health outcomes. Digital health technology can help address health inequities and bridge the gap of care.

Integrating technology-driven patient engagement solutions into a patient’s healthcare journey is a good step toward delivering personalized care that can be tailored to their  unique social and medical needs — but it’s just a first step.

Direct and personalized communications from healthcare providers can help reduce the impact of healthcare disparities among vulnerable populations. Through artificial intelligence (AI) technology, providers can quickly coordinate a personalized care experience, enabling healthcare organizations to efficiently and effectively capture the social needs of their patients.

Addressing AI bias to ensure a more equitable future

The use of AI and machine learning allows providers to more quickly identify areas for targeted intervention, thereby improving the individual patient experience while also improving their overall health and wellbeing. Technology can help intervene by tracking and understanding the non-clinical side of the patient experience, ensuring that SDOH and other factors are being taken into consideration for care.

However, when implementing technology, it is critical that steps are taken to ensure it is unbiased  and does not iterate on biased pretenses. Biases can occur during development, such as when biased datasets are leveraged to build an algorithm. Bias can also occur during deployment of AI.

To prevent bias in AI, algorithms should be developed with the target audience in mind, use representative data, and perform as intended for the audience. Otherwise, technology that is meant to level the playing field can unintentionally further drive inequities.

Making the case for health tech

Using digital health technology that also incorporates the human aspect of healthcare can help address the systemic challenges patients face, bringing health providers one step closer to creating a more equitable system for everyone. The work is just beginning and must continue with purpose and urgency.


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