Social determinants of health inequities are defined as “conditions in the environments in which people are born, live, learn, work, play, worship…”
Typically, electronic health record (EHR) systems are used to record a patient’s contact information, provide a complete medical history, and store important treatment notes. Adding social determinants of health inequities into your EHR’s data provides additional benefits to chiropractic practices.
What are social determinants of health inequities?
The Office of Disease Prevention explains that social determinants of health inequities are defined as “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”
Examples of social determinants include:
- A patient’s socioeconomic conditions, both growing up and current
- Social norms and attitudes based on their race, gender, or sexual orientation
- Whether they have access to a quality education or job training
- Their transportation options, and whether they are reliable
- Their exposure to crime and violence
All of these factors can impact your patient’s health. For example, research reveals that children growing up in low-income households typically have poorer health outcomes. These outcomes continue to be poor even as the child ages and progresses into adulthood. Other studies have connected higher levels of education with improvements in public health.
Social determinants of health versus physical determinants of health
Social determinants of health are different than physical determinants of health. Physical determinants of health involve the patient’s actual environment, such as the building they live in, the design of their home, and what their outdoors landscape is like.
While these physical structures and designs can also add to or detract from a patient’s overall health, they are very different than the determinants found within their social structure. In many cases, social determinants are societal in nature. They cannot be easily changed on an individual level.
Having access to all of the social factors that may be impacting a patient’s health helps chiropractic professionals better understand the health-related issues patients are more likely to face due to their home, work, and social environment. A treatment plan that addresses these potential problems offers a more positive outcome.
Determining relevant social determinants of health
The first step to adding social determinants of health into your EHR is to identify the factors most impactful in your geographical area. One way to obtain this information is through the Centers for Disease Control and Prevention (CDC).
The CDC provides an online listing of sources for data on social determinants of health. From this page, you can access chronic disease indicators based on your state or territory. If you live in a large metropolitan area, data specific to your city may be found as well.
Other sources provided by the CDC include those related to:
- Heart disease and stroke
- HIV and AIDS
- Viral hepatitis and TB
- Sexually transmitted diseases (STDs)
- Exposure to hazards
Another option is to consult with your local health department. Since they work closely with your area’s more vulnerable populations, they have more knowledge of the social determinants most relevant to their physical health.
Collecting social determinants of health information
The next step is to collect information about these factors from your patients. This enables you to identify which social factors have played the largest roles in their lives, providing a better idea of the factors that place them at a greater risk of developing certain health conditions.
This data can be collected from new patients by including relevant questions on your intake forms. Existing patients can be asked to complete updated questionnaires on their next visit.
Sometimes this information can be collected during treatment sessions. While you’re doing the adjustment or discussing the treatment plan, talk to patients about their home and work life. After multiple conversations with numerous patients, certain trends will start to emerge. This will highlight the data that would be most helpful to know when working with your patients.
Adding this information into your EHR
If your EHR has a dedicated patient app, your patients can upload social determinants directly into their electronic file. Otherwise, it may need to be added by your office staff. This option takes more time but pays off via providing patients a more holistic and comprehensive treatment experience.
To make this process more seamless, EHR Intelligence suggests that practitioners begin by screening for only one social determinant. Pick the top issue in your area and add data regarding it to your patients’ files. This streamlines your focus on one social issue at a time while placing less pressure on your staff.
Some EHRs enable you to add social determinants of health inequities on a larger scale. Information can be incorporated based on data provided by public health agencies. This is less personalized than adding individualized data but can be used to help remind you to talk about these factors with your patients, providing a bigger picture view of all the issues that can ultimately impact their health and treatment outcomes.
