Social Determinants of Health: What are They and How Do They Affect You?

Look around you and consider everything that impacts your health and well-being. It’s more than health care; it’s more than the food you eat, the water you drink or how much exercise you get.

All the factors that affect your entire health and quality of life are called social determinants of health, and they include things like access to healthy foods and clean drinking water, education, decent housing, social connections, transportation and more.

How would your life change if you didn’t have access to these things? Life would get a lot harder, wouldn’t it?

“Health care can’t do it alone. That’s why we as Avera partner with hundreds of organizations that help us fulfill the Avera mission to have a positive impact in the lives of persons and communities,” said Micki Lundin, Director of Community Partnerships at Avera.

Understanding Social Determinants of Health

Social determinants of health fall into five domains including:

• Economic stability
• Education access and quality
• Health care access and quality
• Neighborhood and built environment
• Social and community context

“Where you’re born, live and work can have a long-term effect on your health and well-being. As part of Avera’s mission, we work to improve these key indicators so people have a higher chance for success in making the most out of every opportunity. That’s important because the health of a community is only as healthy as its least healthy members,” said Rachael Sherard, Senior Vice President for Rural Health at Avera.

How Social Determinants Impact Health Outcomes

Up to 90% of health outcomes are a result of social, behavioral and economic factors, according to a study published in the American Journal of Preventive Medicine. Consider these scenarios:

• Patient A is diagnosed with high blood pressure. She can take medications to lower it. Yet she’s on the run a lot so she often eats processed foods that are high in salt and fat. She also gets little exercise, and gets stressed out over difficult family dynamics.
• Patient B is known for coming to the emergency room when the weather gets hot with symptoms like headache, nausea and flushed skin. It’s learned that this elderly man lives in substandard housing with no air conditioning.
• Patient C is pregnant and develops gestational diabetes. She lives in a remote area that’s considered a “food desert.” She has little to no access to fresh fruits and vegetables and lean meats, which are vital to controlling her condition.

Over time, these gaps can make a big impact on the whole community as well as local economies. “We believe every person deserves basic human needs and access to health care. We also know a rising tide lifts all boats. In other words, a healthier community overall can have long-term effects on everyone, whether it’s lower health insurance premiums, shorter ER wait times, or amenities like parks and cultural opportunities to enjoy with your family,” Sherard said.

Identifying and Addressing Community Needs

Every three years, non-profit hospitals are required to complete a Community Health Needs Assessment (CHNA). CHNAs are posted on the hospital’s website for the public to read.

“It’s been an engaging journey as we have honed in on the needs of our service area and how we as a non-profit hospital can collaborate with others to meet pressing needs,” said Julie Ward, Vice President of Diversity, Equity and Inclusion at Avera. “Partnerships are important, as well as our own services. For example, here in Sioux Falls, a key need that has long been identified is access to behavioral health services. In answer to that, we have taken steps to broaden our continuum of care with services like addiction care and behavioral health urgent care.”

Other top CHNA goals that Avera addresses include obesity, heart disease, and access to care through transportation programs, and more. For example, to address obesity, Avera Medical Group has launched healthy weight initiatives with resources to help patients.

Partnerships that Make a Difference

Every state has its challenges. These are among South Dakota’s:

• 13.7% of individuals live at or below the poverty line.
• One out of every nine individuals in South Dakota is food insecure.
• South Dakota has one of the lowest average annual wages at $60,000
• 28.9% of South Dakotans over age 25 have a bachelor’s degrees or higher compared to the national average of 31.3%

Through its community partnership program, Avera directs donations toward organizations that serve residents in areas that include food, housing, transportation, education and quality of life.

“Avera has three core values: compassion, hospitality and stewardship. In the spirit of stewardship, we have a process through which organizations submit donation requests,” Lundin said.

See how Avera is working with communities across our footprint.