The United States has the most advanced medicine industry in the world. While it has substantial funding on the novel of high-tech diagnostics and curable treatments, the lack of a pathway to address nonmedical treatment has weakened the American healthcare system. The book "More than Medicine: The Broken Promise of American Health" wrote by Robert M. Kaplan, who is Director of Research at Stanford School of Medicine Clinical Excellence Research Center; he is the author who wrote 20 books and more than 530 articles cited by other authors in his field.
In this book, Robert Kaplan pointed out that America should replace the healthcare priorities from biomedical research to the outside of healthcare systems, such as behavior, social, and environmental, and rethink about determinants of health because about 10% of the variance in health outcomes is linked to the delivery of healthcare in clinical settings when it comes to premature death (Wilson, 2019).
In this book, the concept of cure narrative is the prospect that a severe health problem can be found and treated with medical care. Biomedicine is one reason that speeds up the American medical industry because nothing is more important than having good health. As the COIVD-19 pandemic mercilessly smacking the globe, promising medical technologies cannot prevent contagious infectious disease spreading instead of losing the priorities in the public health system.
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Public health is highly correlative to people's health and living conditions. Studies have shown that poverty is a significant risk factor associated with other health outcomes and can predict health disparity and life expectancy. How can healthcare providers help those people to receive equal healthcare? It is a long way for healthcare providers to think about how social factors affecting health and policy impact the healthcare system.
Social Determinants of Health
Public health has increased on the concept of social determinants of health (SDH). SDH is the nonmedical factor that influences people's health outcomes. The World Health Organization defined it as circumstances that involved people's birth, growth, life, work, age, and the systems to deal with illness (World Health Organization, 2019). Abrams and Szefler (2020) indicated that many social determinants of health, including poverty, physical environment, behaviors, race, or ethnicity, considerably affect equity health outcomes.
Equity in health care requires that health needs determine resource appropriation and access to health care. To address health outcomes that correlate to social determinants of health, physicians, policymakers, communities, and individuals need to understand these factors play in individual and community health and target public policies that reach the most significant number of people while aiming daily needs for individuals in their communities (Daniel, 2018).
Socioeconomic Status
The primary factor to discuss SDH is socioeconomic status. Wealthy people can gain proper healthcare compared to poor people, and education level indicates capabilities to access healthcare and recognize the health policies and occupations that can support finance. Continuing living in poverty has shown short-term and long-term impacts on health outcomes. The nutrient is fundamental for buildup a healthy body and provides energy for daily activities. The shortage of fresh and affordable healthy food needs to be addressed in the school-age population. Alcaraz et al. (2019) claimed that food insecurity might result in parents or children purchasing inexpensive and unhealthy food. This will lead them to pay for more medical expenses to enhance risks in childhood obesity, metabolic syndrome, and heart disease.
Moreover, socioeconomic status also links to racial and ethnic disparities. Alcaraz et al. (2019) described that discrimination and stigmatization in some racial and ethnic groups significantly contribute to social inequities. Both are rooted at the societal-structural level that presented social conditions and norms systemically drawback in particular. Imbalanced a type of structural in housing, health, or education engenders inequitable access to social and economic resources. There is offending to diversity race and provoke racial health disparities. However, these are real issues that influence society.
Daniel (2018) pointed out that an estimated 38% of the excess mortality among African American adults versus white non-Latino adults is related to income and health inequity. If we left issues blank, social-structural determinants might inhibit intervention efficacy and sustainability, preventing long-term health equity (Alcaraz et al., 2019). Social inequities are primary conditions that create health inequities and consequent disparities in health. The best way to know why social factors cause health problems is to find out the underlying reason and solved it (Kaplan, 2019).
Behavior
Social risk factors and behavioral risk factors are individual but highly interweaved (Alderwick & Gottlieb, 2019). Social risks are the mirror that reflected an individual s behavior, and it associates with an unhealthy living style in which smoking, alcohol consumption, substance overuse, inactive life, and unhealthy diet. Therefore, to modify the behavior needs to start with social factors. For example, they live in a community with a lack of supermarkets but lots of fast- food stores or trying to exercise, but there are no available facilities or equipment to use. They are typical examples to illustrate conflating behavioral and social risks that could confuse public focus too heavily on individual behaviors, which risks amplified health inequities.
Therefore, provide intervention to an individual or refer them to the agencies to seek assistance in whether they are unemployed or support food and housing. Alderwick and Gottlieb (2019) state that improving population health requires putting all healthcare facilities and organizations' effort into practice with local government, social services agencies, schools, and community-based organizations. Public health is the root of health, Medicine, and society; without state and federal cooperation, significant policy intervention will not be implemented.
Environment
Accessibility is a priority for people to get medical attention. However, in some places, transportation is a complicated issue to overcome when receiving proper healthcare. Transportation allows individuals to go to work, receive education, purchase healthy food, access health care, and other resources. Alcaraz et al. (2019) stated that approximately 3.6 million Americans miss at least one medical visit each year due to lack of transportation. Inadequately transportation is an obstacle for disadvantaged communities to seek healthcare and medical attention.
Although there are different ways to reach healthcare facilities, it usually takes time and money. Having good communication and policy delivery with the local community and transporting company to see reasonable cooperation could control both parties' cost and service satisfaction.
It is essential to understand affecting factors than focusing on medical. The factors like food security, physical living, or access to healthcare are the most concern for those vulnerable populations. Although understanding the effects of all factors on health are changeable, monitored by governments and international agencies, and the activities that resources will support earmarked to address health inequalities or health equity.
Application in Practice and Policy
The idea of maintaining well-being is a prominent concept in the medical field. Behavior, social interaction, and environment are vital factors for health outcomes. Public health policies are broad contextual guidelines that bring an exclusive message communicated to policymakers, healthcare providers, and decision-makers (Wilson, 2019). Greater clarity on key terms and the underlying concepts that go with these could advance policies and practices related to social determinants of health, including defining appropriate roles and limits of the health care sector in this multisector field (Alderwick & Gottlibe, 2019).
The ability for our field to communicate cost-effectiveness data to policymakers, employers, and insurers (that incorporates implementation costs as well as medical cost offsets) impacts both health and non-healthcare sectors. This is paramount to the likelihood of our interventions being adopted (Wilson, 2019).
Poverty is a social phenomenon that cannot be solved; most people who live in poverty will not receive equal and quality healthcare services. Because of poverty, this population faces more hardship to receive education, get a job, and improve the physical environment. Government can enact healthcare policies to address public needs in most and increases preventive services that are easy to implement and access. Indeed, this is a challenge requires to produce the most health for the most people when limited resources available. Although reconstructive healthcare systems sound ridiculous, establish a transparent healthcare standard to reduce overtreatment, costly, and unnecessary treatments can be the first step to reform.
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