What do you think are the primary influences on the health of Canadians? Most of us might say advanced medical treatments,
leading-edge surgery, or access to expensive pharma treatments. But we would only be partially correct: in fact, it’s becoming clear that a broad range of social factors are the most critical indicators in determining an individual’s health. Health policy experts are turning their attention to the personal, social, economic, and environmental factors such as education, housing, employment, and education known as the social determinants of health.
Recent data from University Health Network shows that more than 57 per cent of high-needs patients with chronic disease live in low-income neighbourhoods or lack access to stable housing. To best support complex patients such as these, whose needs go beyond just medical attention, we need to be able to identify them as they interact with various parts of health system.
But how? Part of the answer lies in the collection, safe storage, and analysis of comprehensive, reliable patient data. Data access and analytics are key to serving these patients better and making sure they receive the treatment and services that they require to return to and stay in good health.
An initiative such as this — following a patient through their health care journey and making sure they have access to any and all services that will support them in their wellness journey — will require an unprecedented level of collaboration, engaging a broader groups of voices in design and reconsidering what works best for the different individuals. Communication amongst teams and organizations who may not have collaborated together will require a new level of coordination and most likely will also require new communication platforms.
The most effective health care system is one that addresses social needs that affect entire communities. At the same time, this serves to reduce the number of patients requiring higher levels of care and in the end the burden on health and social services would decrease. This new level of collaboration will also require sharing of data between hospitals, primary care givers, and community care, which currently remains fragmented. Going beyond that, to looking at paramedic services data sets, community housing data and much more, is necessary.
A co-ordination of systems across health care providers would make it much easier for patients to access services without having to navigate overwhelming, confusing, and disparate systems. Social medicine requires traditional medical supports but must also address housing and food insecurity. It is possible to improve the health of Canadians but it will require a more holistic view of communities, public programs and policies.
How can digital health help? The digital health community must also look at how we can enable this holistic view. For example, by incorporating the transportation, financial, housing, employment, language, and education barriers that may be preventing patients from easily accessing the care they need or acting on their clinician’s recommendations.
As a community, we will need to rethink how we approach this challenge. We will also need to look broadening our partnerships and collaborations. Are we ready for this? Is there an app for that?
What do you think is the greatest social determinant of health? How can we facilitate agencies working together to benefit the health of all Canadians? I welcome your comments. Please contact me at firstname.lastname@example.org.