Please note: this post isn’t intended to be a scholarly research article. Instead, it’s intended to be easy to read, mildly informative, and hopefully a bit thought-provoking. We hope you read it, think about it, and then check out some of the links at the end to discover more.
Social determinants of health are the factors in a person’s life (apart from medical care) that affect their health and well-being. They fall into five categories: economic stability, education access and quality, healthn care access and quality, neighborhood and built environment, and social and community context. If you missed it, you can read our Brief Overview of the Social Determinants of Health here.
In this blog post, we are going to look at how both access to health care and the quality of health care are social determinants of health. There is a lot to unpack when it comes to health care and we know that we can’t possibly touch on everything but we will focus on some key areas.
First, let’s talk about health insurance. Prior to the COVID-19 pandemic, 1 in 10 adults didn’t have health insurance and that number may have increased in the past year. Without health insurance, many people do not visit a primary provider for preventative care and many health problems go undiagnosed. Without health insurance, many people are unable to afford prescriptions they need to keep them healthy (heck, even with health insurance some prescriptions are still way too expensive, but that’s for another day). But the problem also goes beyond primary care and prescriptions, there are mental health services, chronic illness treatment, treatment for substance abuse and nicotine addiction, cancer treatments, emergencies, accidents, and the list goes on and on. Health care is expensive. Health insurance helps pay for those expenses, but without health insurance, many people simply cannot afford access to quality health care.
Access to health care is more than just being able to afford it. It can also mean not being able to get to a health service provider. Lack of transportation is one barrier some people face. Physical distance is also a barrier. There are few providers in rural areas, so many people lack access to a provider where they live and work. It isn’t unheard of for people to have to drive (or find someone to drive them) more than 40 minutes and up to 2 hours just to see a specialist. For many, their jobs or family situations make it almost impossible to go to health care appointments when they are so far away. Even those who do have health insurance may not get the care they need because of transportation or distance issues.
Health literacy can also be a barrier to accessing quality health care. We discussed this in our last blog post but it’s also very important when it comes to health care access. Nine out of ten adults struggle to understand and use health information when it is unfamiliar or complicated. Not understanding health information can make people sicker and cost them money. One small step we have taken is through our Taking Charge of Your Health booklets that we have placed in Little Free Libraries in North Carolina. We know that understanding health information and available services is necessary for people to make good health choices.
Finding and accessing quality health care isn’t easy for many people. There are many barriers. It could be because they lack health insurance, or they live far away from a quality provider, or they are unable to leave their job or caretaker responsibilities, or it could be they simply lack the health literacy to make the right choice for their health. We’ve only touched on a few in this blog but there are more. The good news is that there are many organizations that understand social determinants of health contribute to health disparities. These organizations are taking action. The US Department of Health and Human Services aims to improve health and well-being over the next decade with their Healthy People 2030 objectives. The North Carolina Department of Health and Human Services is also focused on Healthy Opportunities and is working to make sure all North Carolinians have the opportunity to live healthy lives. NCAH is also working to advance policies that will ensure that every North Carolinian has the opportunity to attain their highest level of health. We have many amazing partners, members, and allies who are advancing health equity and responding to health disparities. You can join in the discussion and learn more about what is happening across the state and how you can help.