Healthcare isn’t limited to the short amount of time you spend at a clinic or the brief interactions you may have with your provider. Every action we take and choice we make affects our health, long before we visit a doctor. Exercising regularly, sleeping well, eating healthy meals, and properly managing our conditions all play a huge role in determining long-term health outcomes. But there’s a problem here: for many patients, social determinants of health make it far more difficult to practice healthy behaviors and achieve their health goals.
In the second entry in our Social Determinants of Health blog series, we’re discussing the social and economic factors that can prevent healthy behaviors in the long-run while presenting ways that you can support your patients’ long-term health.
Inaccessibility of exercise
We all know that exercising regularly is often much easier said than done. When you’re working long hours, have a tiring commute, and still want to spend time with your family, squeezing in trips to the gym is a major challenge. This issue is exacerbated in low-income communities: public safety is a real issue in some neighborhoods, and criminal activity discourages residents from walking, running, or biking outside. Less affluent neighborhoods also have far fewer parks or centers for recreation, making it difficult to stay physically active. And both personal exercise equipment and gym memberships can be expensive. It’s easy to feel defeated in a situation like this and give up any hope of regular physical activity.
Providers can play a huge role in promoting exercise with patients. Treating physical fitness as a prescription that’s equally almost as important as blood pressure medication can go miles for patients, and sending regular tips for easy ways to get exercise helps patients feel empowered by their trusted health coach. Even small lifestyle changes can make a huge difference: walking, for example, is a low-impact activity that has massive health benefits. Parking a little farther away from the office or store, taking the stairs instead of the escalator, or taking periodic breaks from work to pace the office are small changes that can add up to huge health benefits. Some health centers are even offering Zumba classes and other fitness classes that are free and accessible to patients of all ages. The path to improving physical health isn’t a sprint, it’s a marathon. And in this case, it can be a walking marathon!
Encouraging health literacy
It’s said that knowledge is power, and that’s especially true in healthcare. In order to achieve better care outcomes, patients must be equipped with the information necessary to take control of their health. Unfortunately 30 million people, or 14 percent of U.S. adults, have “Below Basic” health literacy, meaning they lack the necessary information to effectively manage their health.
Disseminating accurate information is the number-one way to fix this issue. PSA campaigns are a great place to start helping patients learn about health risks and the importance of preventive care. The most effective campaigns use a variety of channels—public transportation, television, social media, and more—to share their information, ensuring that all patients have the chance to read it. Support PSAs, ensure that they’re accurate, and maybe even distribute your own ads. It’s worth it: the importance of health education and literacy cannot be underestimated.
The way providers communicate with their patients matters too. Using plain English with patients and easy-to-understand words, not medical jargon, can simplify the complexities of clinical care. Make sure to repeat important points multiple times and check that patients remember and understand these points. Small adjustments such as these go a long way to increasing patients’ health literacy. Patients must be well-informed and empowered to handle their own health, and you can help equip them with the facts they need to make that a reality.
Many low-income communities—approximately half—are located in what’s known as “food deserts” where there are no grocery stores and the only affordable food options are fast-food restaurants. Living in a food desert makes it extremely difficult for children and families to receive adequate nutrition.
As with exercise, providers can make a huge impact by prescribing healthy eating. And just like exercising, small improvements in diet will improve outcomes over time. The awareness component is also key: many myths and conflicting stories are swirling around the notion of “eating healthy.” It can be confusing, especially when healthy food requires an investment of time and money, both of which are in limited supply in low-income communities. Short and sweet tips for making affordable healthy choices can go a long way. It’s a lot to tackle, but it’ll pay off in dividends. By taking these steps, you’ll be empowering your patients to become healthier, happier, and better-informed.
Chronic disease management
Over half of all US adults have been diagnosed with a chronic disease, but patients with limited resources and time struggle to regularly check their vitals or stay up-to-date with their medication. They also tend to face much higher stress levels that can exacerbate their conditions.
The good news is that you can make it easy for patients to practice self-management. Reaching them in the way they want to be reached — usually, via text message — can help patients remember to pick up their prescription, to make an appointment for a check-up, or to check their blood pressure between visits. Providers can also allow patients to ask questions between visits via a mobile-friendly platform so that no question goes unanswered. Arming patients with the information, tools, and reminders they need is fundamental to helping those living with chronic conditions manage and improve their health.
When a person facing social determinants comes to you for care, the work you do may be hindered by the effects of long-term behaviors. But even outside of the four walls of your clinic or system, you are being held more and more responsible for your patients’ long-term health. That means we all have to time to start paying more attention to the patient behaviors that are fundamental to health and wellbeing.