It is Time to Rethink Social Determinants
What is the most critical word in the phrase "Social Determinants of Health?"
"Determinants" is quickly replaced by synonyms like "Causes" or "Factors," so that isn't it. And few things are less deterministic than human society.
What about Health? Look at the lump-it-all-together definition from the World Health Organization.
"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
Social is the real problem. And it is way bigger and more deeply embedded than healthcare. Education, business, government, and almost every aspect of everyday life is crippled.
Healthcare is correct to care about social issues. In June 2022, Deloitte calculated that social factors cost around $320B annually, which could eclipse $1T by 2040. Yet just because this is a problem for healthcare, it doesn't mean this is a healthcare problem. Instead, it is a problem for everyone.
On the medical side, the focus is on the biological health of each person. Because human biology has been stable for over 75,000 years, high-quality science and technology, expertise, skill, and an engaging bedside manner deliver sustainable patient improvement. Of course, none of our internal organs have independent minds. This approach will fail in the social system because it is radically different.
At the social end of the spectrum, everyone has agency and a mind of their own. Moreover, every problem a client has is intimately integrated into a network of surrounding interdependencies. Thus, unlike when I practiced medicine, science, expertise, and skill aren't even close to enough.
Learning from California
If you want an example of a different approach to delivering actual improvement, check out the final evaluation of California's Whole Person Care Program by the UCLA Center for Health Policy Research. The final report, published on Feb 8, 2023, is here.
The crucial importance and unique requirements of the system we call community is why Curandi's focus is social system integration.
Curandi's integration model takes advantage of social complexity to support sustainable solutions.
We can help people and lower costs at the same time. Check us out.