Let’s Talk Social Determinants of Health

August 6, 2019

Let’s Talk Social Determinants of Health

Today I want to talk about something that I as an individual, and we as a healthcare industry, think a lot about: social determinants of health.

Let’s start by answering the basics: what are “social determinants of health”? As Massachusetts General Hospital’s Center for Community Health Improvement explains:

A lot of people think that good health is determined by their access to doctors. While that’s obviously important, about 80 percent of health status is determined by the social and economic conditions where you live and work. These social determinants of health include the financial and social supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships.

Today as Chief Medical Officer of Zipnosis I think about the role virtual care can play in addressing social determinants of health on a daily basis. Virtual care makes healthcare more accessible to people who lack schedule flexibility, who don’t have transportation, who need a less expensive care option, who live in rural settings, or who have a high deductible insurance plan or no insurance at all. But my passion for increasing access to care and addressing social determinants of health didn’t start with my tenure at Zipnosis, it started years ago… 21 years ago to be exact.

21 years ago I started working with the Center for Victims of Torture (CVT) in St. Paul, MN several times per month offering medical services. The CVT is a nonprofit organization that heals the wounds of torture on individuals, their families, and their communities, serving as a safe haven for refugees and asylum-seekers from around the world. When providing medical care to refugees and asylum-seekers it quickly becomes apparent how much their health is impacted by external social factors. Do they have food readily available? Do they have a bed to sleep in? Do they have family close by? What is their health literacy?

To this day I continue to work with the CVT and it wouldn’t be an exaggeration to call it my heart’s passion. In fact, while interviewing at Zipnosis I recall telling Jon Pearce, our CEO, that having the flexibility to work with CVT patients twice a month was non-negotiable for me. I have since learned I was talking to a kindred spirit who is equally committed to increasing access to care, so it won’t surprise you to hear he quickly agreed and even wrote the freedom to work with the CVT into my hiring contract.

I share this background not because I have the secrets to addressing social determinants of health, though I would argue virtual care plays an important role in that scenario, but rather because we as health care providers (in any capacity) must remember we are working to help real people. Real people with many diverse factors that impact their health.


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