By Dr. Joe Nicholson
Although the long-term economic impacts of COVID-19 remain unclear, the ramifications will probably outlast the public health crisis and be felt for years to come.
This is especially true for socioeconomically disadvantaged populations, including racial and ethnic minorities, for which the crisis has been particularly hard. Not only are these groups more likely to get sick and die from COVID-19, they are also more likely to lose their jobs or see their wages cut as a result of the crisis. And even though employment is rising and household budget constraints have eased in recent months, the employment rate remains below pre-pandemic levels, and millions of households still report experiencing challenges with food insecurity, housing insecurity, and transportation issues.
What does this economic uncertainty mean for people’s health?
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There is an undeniable link between a patient’s health and several socioeconomic and environmental factors—also known as social determinants of health (SDOH). Conditions like an unsafe home environment, food insecurity, homelessness, and limited access to health care can impact a staggering 50 percent of patient outcomes. In fact, SDOH can affect outcomes just as much as patient behaviors (mental health, diet, and physical activity) and the clinical care an individual receives.
It is not surprising that concerns about money, transportation, food, and housing prevent people from concentrating on their health. However, when those fears are coupled with a lack of access to care, the roadblocks get even bigger. And when there is a massive public health crisis like COVID-19, it shines a spotlight on the almost insurmountable difficulties certain populations face in receiving urgent and specialized care—and what the ramifications of those hurdles are.
Essentially, the pandemic has widened the gap between the "haves" and the "have-nots," and the people who struggled with SDOH factors before the pandemic are struggling more now, and without support, they will continue to struggle going forward, even as other populations move beyond the crisis and regain their economic footing.
Health care organizations have an obligation to step up
Providing the best possible care is part of almost every health care organization’s mission. Yet, if we downplay, overlook, or disregard the role of SDOH in improving the health of our patients, we not only fall short of our mission, but we do our patients a disservice. Even though we cannot entirely fix the psychosocial and environmental factors that exist today, we can recognize their impact and try to make a difference in the lives of those we serve. Although this may seem daunting—and in many ways it is—there are some fundamental things we can and should be doing now.