Social determinants are areas of health that involve an individual’s social and environmental condition as well as experiences that directly impact health and health status. Here, Dr. Randall Williams, chief executive officer, Pharos Innovations, examines why, contrary to popular thought, technology advances may actually increase the gap between social connectedness and social isolation for certain populations.
In the age of the Internet, technology itself may become a barrier to being connected with others through social interactions. The Pew Research Center has done some nice work on health and the Internet. It turns out that three quarters of adults in the United States go online. That's probably not all that surprising, but what's more nuanced in this data is that the Internet access of individuals in the United States actually differs, depending on whether or not those individuals suffer from chronic health conditions.
It turns out that of Americans who have two or more chronic conditions, which by the way represents the vast majority of the Medicare population, only half go online. As it turns out, the very same groups that suffer most from social determinants of health, and not just from social isolation, also have the highest rates of chronic disease. And according to this research, they are the ones most likely to NOT have access to the Internet. This is called the Internet Divide.
We might be encouraged by the prevalence and penetration of mobile technologies, and maybe those would be the great bridge over the Internet Divide. Unfortunately, that may not be the case yet. According to this same Pew research, 90 percent of Americans who don't have a chronic condition actually own a cellphone. However, if you do have two or more chronic conditions, that number drops down pretty dramatically to 70 percent. That finding is a bit better than Internet access, but certainly not ubiquitous. If you look at those who have a cellphone, only 23 percent of them actually access text-messaging technologies on their cellphones, and smartphone apps fall well below that.
In Social Determinants and Population Health: Redesigning Care Management to Bridge Clinical and Non-Medical Services, care teams will learn that by asking patients the right questions and listening carefully to their responses, they can begin to identify and address social determinants, dramatically impacting patient outcomes as well as their own financial success under value-based care.