Social Determinants of Health: The Impact of This Overlooked Vital Sign
Katarina Vrtikapa, Farhana Hoque Urmy, Farzana Hoque
Abstract
Social determinants of health (SDOH)-conditions where individuals live, learn, work, and socialize-significantly influence health disparities and patient care outcomes. SDOH can be categorized into five key domains: economic stability, access to quality education, access to quality healthcare, neighborhood environments, and social support. Structural barriers such as economic inequality, limited transportation, and discrimination directly impact patients' willingness and ability to access care. Transportation barriers, notably among low-income and elderly populations, often result in delayed or missed care and worsening health outcomes. Within healthcare settings, disparities persist, with publicly insured and low socioeconomic status (SES) patients experiencing higher rates of adverse events, suboptimal treatment, and poorer clinical outcomes. Low SES patients typically receive less thorough clinician communication and report negative healthcare experiences, reducing trust and patient engagement. These disparities extend to post-hospitalization care, where unstable housing and limited community support increase hospital readmissions and reduce access to necessary follow-up care. Policy interventions, such as Medicaid expansion and Medicare's Transitional Care Management program, have successfully reduced healthcare disparities, yet broader systemic approaches remain essential. Understanding and addressing the role of SDOH at every stage-from initial care-seeking to post-discharge recovery-is vital for healthcare systems aiming to deliver equitable, inclusive care and improve long-term outcomes for vulnerable patient populations.