Health Care Law and Legislation, Statistics Policies
Chapter 7
Social Determinants of Health and the Role of Law in Optimizing Health
Chapter Overview
- Describes the meaning of “social determinants of health” and the significance of social factors on individual and population health
- Describes how law can create or perpetuate health-harming social conditions
- Explains how law can be used to ameliorate health-harming social conditions
- Explains how innovative interventions to improve health, such as medical-legal partnership, can help address health-harming social conditions at the individual and population levels
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Background
(1 of 2)
- Health disparity—when one population group experiences a higher burden of disability or illness than another group
- Healthcare disparity—denotes differences in access to healthcare services or health insurance, or in the quality of care actually received
- Health equity—a situation in which everyone has the opportunity to attain his or her full health potential
- As long as these disparities exist, a society cannot achieve health equity.
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Background
(2 of 2)
- Many factors contribute to health and healthcare disparities, including:
- Individual behaviors, healthcare provider bias, cultural expectations and differences, location and financing of healthcare systems, social factors, and more
- Disparities appear through different lenses.
- Race, ethnicity, socioeconomic status, age, geography, language, gender, disability status, citizenship status, and sexual identity and orientation
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Determinants of Health
- According to the Centers for Disease Control and Prevention (CDC), determinants of health are “factors that contribute to a person’s current state of health.”
- Biological factors—genetic mutation that could increase chances of developing a disease (sickle cell anemia)
- Psychosocial factors—conflicts within one’s family that may lead to stress, anger, and/or depression
- Behavioral factors—alcohol/drug use, smoking, unprotected sex
- Social factors—conditions in which people are born and that affect their daily lives and overall well-being as they move through various stages of life
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Defining Social
Determinants of Health
- Social determinants of health (SDH)—social conditions into which people are born and that affect their daily lives and overall well-being as they move through life
- World Health Organization (WHO) defines SDH as: “the conditions in which people are born, grow, live, work and age”
- Centers for Disease Control and Prevention (CDC): SDH are shaped by the distribution of money, power, and resources at both local and national levels
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Types of Social Determinants
of Health
(1 of 2)
- Access to high-quality educational opportunities
- Access to medical care services
- Access to social media and other technologies
- Availability of community-based resources and opportunities for recreational activities
- Availability of resources to meet daily needs
Types of Social Determinants
of Health
(2 of 2)
- Culture
- Language/literacy
- Public safety
- Residential segregation
- Social norms and attitudes
- Socioeconomic conditions
- Transportation options
The Link Between Social Determinants and Health Outcomes
- While most diseases and injuries have multiple causes, and while several factors and conditions contribute to a single death, the overwhelming weight of evidence demonstrates the powerful effects of socioeconomic and related social factors on health.
Law as a Social Determinant
of Health
(1 of 2)
- The law can be used to design and perpetuate social conditions that can have terrible physical, mental, and emotional effects on individuals and populations.
- The law can be utilized as a mechanism through which behaviors and prejudices are transformed into distributions of well-being among populations.
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Law as a Social Determinant
of Health
(2 of 2)
- Laws can be determinative of health through under-enforcement.
- The law can be used to structure direct responses to health-harming social needs that result from things like impoverishment, illness, market failure, and individual behavior that harms others.
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Right to Criminal Legal Representation Versus Civil Legal Assistance
- While the right to legal representation exists in criminal matters, there is no right to a lawyer in civil matters.
- Common civil legal matters involve immigration status, domestic violence, disability law, family law, housing needs, public benefits (e.g., Medicaid, food stamps, Social Security), employment disputes, and special education needs.
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Combating Health-Harming Social Conditions Through Medical-Legal Partnership
- Medical-legal partnerships function as a patient care team that includes both medical and legal professionals.
- A legal services attorney is embedded in a medical care setting (hospital, community health center, etc.) to address underlying social conditions that negatively affect patient health but whose remediation is outside the expertise of traditional healthcare providers.
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