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Social Determinants of Health Sheila D. Bouldin, MD “Health inequalities and the social determinants of health are not a footnote to the determinants of health. They are the main issue.” —Michael Marmot
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s a physician in a primary care specialty, I see patients daily with at least one or more preventable chronic health conditions such as type 2 diabetes, hypertension, obesity, and heart disease. A majority of patients with chronic diseases are among the five groups classified as vulnerable populations: chronically ill and disabled; low-income and homeless individuals; specific geographical communities such as rural populations; the LGBTQ+ population; and, the very young and very old.1 Social factors may exacerbate the health and health care needs of these populations. What are social determinants of health? Social determinants of health are a combination of personal, social, environmental, and economic factors that all play a role in one’s health. Physicians, other health care providers, and health care institutions should be cognizant of and address social determinants of health when providing patient care. As physicians, we should address these social determinants of health, including economic stability, education, social and community context, access to health care, and neighborhood and built environment. Acknowledging these social determinants could change how we practice medicine and the health outcomes for our state. The COVID-19 pandemic has shed additional light on the many health care disparities that exist in the African-American community. In Mississippi and across the U.S., more African-Americans were infected
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with the coronavirus and died as a result of the coronavirus than any other race. Could addressing social determinants of health earlier have made a difference in the mortality and morbidity associated with COVID-19? There are vast opportunities to close these gaps in health care. n Reference 1. Joszt L. 5 Vulnerable populations in healthcare [blog post]. Am J Man Care. Published July 20, 2018. Accessed April 20, 2020. https://www.ajmc.com/newsroom/5-vulnerable-populations-in-healthcare
Dr. Bouldin is a board-certified obstetrician and gynecologist at the University of Mississippi Medical Center and chair of the MSMA Committee on Publications. She has over 20 years of experience taking care of the overall health care needs of women throughout all phases of their lives. This includes care across several generations, starting from adolescence to the menopausal years. Her experience has been as a private community physician and as an academician in the university setting, providing general obstetrics and gynecology care.
Katherine G. Pannel, DO
Psychiatrist & Medical Director ®
Quality outpatient mental healthcare in Mississippi ✔ PSYCHIATRIC EVALUATION ✔ MEDICATION MANAGEMENT
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170 vol. 61 • no. 6/7 • 2020
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