Expert Health Articles

Social Determinants of Health

The U.S. economy spends around 18 percent of the gross national product on healthcare needs. This includes payments to doctors, dentists and other professionals in addition to pharmaceuticals and other medical devices. Hospitals and nursing homes are other buckets of spending.

Despite the highest per capital spend of any international country, the U.S. does not rank very high in healthcare outcomes such as mortality rates, life expectancy and hospital readmissions. Why is this so? Many policy experts attribute the fee-for-service, episodic, crisis mentality with the lack of emphasis on education and prevention as a cause. Certainly, these factors play a role, but increasingly it has been found that social determinants are the best indicators of health status. In fact, the opposite of health is poverty.

Why is that so? First, medical care contributes about 20 percent to the outcomes of health in a population. Genetics or inheritance another 20 percent. The rest are such determinants as income, transportation, housing, food and nutrition, safety and violence, as well as educational achievement. Even when there is access to affordable, quality care, the inability to pay for medications, travel to clinics or obtain good nutrition are serious impediments to health.

These problems can only be solved with a community commitment to improve these various gaps. Increasingly, it is apparent that the partnerships among providers, social service agencies, religious organizations, educational institutions and government, as well as businesses, have a role to play. The Hancock County Be Healthy Now coalition, which is currently developing action plans to improve the health and well-being of our community, continues to look for feedback as to needs and ideas for local solutions. 

Every effort in filling gaps in physical, mental and spiritual health makes incremental improvements for the betterment of our community. Everyone is encouraged to complete a brief survey available on the Hancock Public Health website to capture your thoughts.

William Kose, MD, JD
Vice President of Special Projects
Blanchard Valley Health System