Though in some instances social determinants are subtle, they play a very critical role in determining the health outcomes of a society. Social determinants have contributed greatly to health disparities and inequalities to accessing the services.
Coming up with health policies that guide on social determinants such as education (access and quality), healthcare access, economic stability, social and community will help reduce the disparities and inequalities in healthcare access. This is because once an individual is sick the disease does not care what the social determinant is at play. For example, diabetes treatment is similar for the poor as is for the rich, for the educated as for the uneducated and thus the importance of the policies that is all inclusive for best health outcomes.
Coming up with such policies may not necessarily be easy and not all the social determinants can be considered 100%. However, according to Jayesh Saini, there is always a middle ground that works favorably for all to benefit irrespective of the social status. Citing as an example of how the social determinants can make or break delivery, Jayesh said there are times when some patients will be adamant that they cannot be examined by male/female doctors. In such a scenario, listening to the concerns of the patient can be alleviated by including the presence of a person of the other gender in the examination room especially if the patient is critically ill and needs immediate intervention. If the patient is not too badly off in such a case, and explaining that the doctor available is not of the preferred gender and the unwillingness of the patient to have another person in the room, the patient can be advised to seek services elsewhere. In such cases, patients have in many occasions realized the inhibitions of their demands and have agreed to the set guidelines as they understand the complexity of the health industry. Where religion or culture is the main focus of concern, medics are posted with that in mind as far as it is possible; with many being locals who are engaged. Education remains a very key component to ensure acceptability out of the norm as long as it does not belittle the concerns but helps alleviate the discomfort.
Policies that focus on affordable, easily accessible quality health services for all indirectly consider all the determinants. This should include both the healthcare and non-healthcare sectors to optimally shape policies and practices in ways that promote health and health equity. Considering the various payer systems and initiatives applicable, the players should also be included for focused initiatives that address social needs for improved health outcomes.
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