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National Health Rankings Highlight Health Disparities, SDOH

Looking at state rankings based on patient health underscores the prevalence of health disparities often caused by the social determinants of health.

health disparities sdoh

Source: Thinkstock

By Sara Heath

- New insights about the nation’s health and life expectancy shines a light on the social determinants of health and how those factors impact health disparities and wellness in different communities.

While the 2018 America’s Health Ranking from the United Health Foundation revealed that childhood poverty rates are decreasing, communities are experiencing influxes of adult obesity and chronic illness that are onset by adverse social determinants of health.

The social determinants of health are the various social factors that impact an individual’s or a community’s ability to obtain wellness.

The report, which looked at various health indicators in each individual state, found that adult obesity is at an all-time high. For the first time ever, the obesity rate exceeded 30 percent, coming in at 31.3 percent of adults who are obese.

Increases in the obesity set the stage for more industry-wide issues. Obesity is a significant indicator of other health issues and often leads to certain chronic illnesses, according to Rhonda Randall, DO, chief medical officer of UnitedHealthcare National Markets.

“This year’s Annual Report spotlights an obesity problem that continues to grow. This means more people will likely develop obesity-related chronic diseases like cardiovascular disease, diabetes and cancer,” Randall, who is also an adviser to America’s Health Rankings, said in a statement. “We encourage health professionals, public health officials and elected leaders to use these findings to explore opportunities to better support people in their communities in all aspects of their health.”

The report also found that premature deaths are also at a high, with 7,432 individual lives lost before they hit age 75.

Furthermore, the suicide rate is increasing. The suicide rate has increased 16 percent since 2012, with 13.9 deaths per 100,000 people occurring in 2018.

Not all is lost, the report authors stated. Childhood poverty, which many experts regard as a strong indicator of socioeconomic status and health status, is going down. Since 2013, the childhood poverty rate has decreased 19 percent, from 22.6 percent of children living in poverty in 2013 to only 6 percent living in poverty in 2018.

These improvements could indicate a better path forward in the future, with decreased likelihood of individuals developing costly chronic illnesses.

“Exposure to chronic stress associated with financial hardship — including unreliable access to food, health care and stable housing — may impair childhood development and affect health into adulthood,” the report noted.

However, improvements in childhood poverty levels are disparate, the report authors said. In Louisiana, for example, childhood poverty rates reached 28 percent; in New Hampshire, rates reached just 13 percent.

The report’s authors strongly indicated that the social determinants of health had an impact on certain health disparities that emerged in the report. For example, patients living in certain states saw significantly higher suicide rates than those living in other areas.

In Montana, the suicide rate reached 26 deaths per 100,000 individuals. In New Jersey, that number was just 7.5 deaths per 100,000 people.

Additionally, the report authors recognized the role the social determinants of health play in individuals developing chronic illnesses and those individuals’ abilities to manage their illnesses.

Chronic illness can certainly be managed by relevant providers and other healthcare stakeholders. The nation is slated to meet this need, the report authors said. In the past year, the number of primary care providers per 100,000 patients increased 5 percent. The number of mental healthcare providers per 100,000 individuals increased 8 percent during the same time period.

This is good news, especially considering the physician shortage that has garnered attention across the healthcare industry.

But just as improvements in childhood poverty rates were varied according to region, so too are physician workforce numbers. In rural states such as Alabama, the physician shortage persists, especially when compared to more urban areas such as Massachusetts.

These findings suggest that it will take more than just physical health interventions to prevent and manage chronic illness, the report authors stated. Community health programs and other policy efforts will be critical.

“While the country’s ability to address treatment of chronic conditions may improve with increasing numbers of key health providers, interventions and policies at the individual, community, state and national levels are needed to curb these troubling trends,” the authors concluded.

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