Better health starts with addressing social issues
By Mikelle Moore
Aug 15, 2019
Updated Nov 17, 2023
5 min read
When you go to see your doctor, you pretty much know what you’re going to talk about: Your blood pressure, your diagnostic results, your prescriptions, recommendations to help you feel better, etc.
But what if your doctor asked about your debt-to-income ratio? Or how often you worry about not having enough to eat? Or whether you worry about your job security, the safety of your neighborhood, or your access to affordable child care?
While questions like that might not seem relevant or even appropriate during a doctor’s appointment, the reality is things like housing, social support, and financial security all have a profound impact on our health.
I recently chatted with Dr. Adaeze Enekwechi, president of IMPAQ International, a research and policy group dedicated to using innovative thinking to solve global problems. She says healthier individuals and healthier communities start with addressing the environmental forces that influence people’s health risks and outcomes, which are often called the social determinants of health.
“We often go after the low-hanging fruit,” Dr. Enekwechi said. “Things like transportation don’t require a lot of thought. If an expecting mother can’t afford to get to the doctor for prenatal care, we give her a transportation voucher and assume we’ve done our part. But when you dig deeper, you realize there’s often more to the problem. Sometimes she has other small children at home and can’t afford child care, so she doesn’t go to the doctor. That’s the real issue that impacts her health and the health of her unborn child. It’s not solved with a bus voucher.”
Intermountain Healthcare’s mission is to help people live the healthiest lives possible, and that extends well beyond vaccinations, checkups, and healing broken bones. As an organization, Intermountain invests in the social needs of the communities we serve, because contributing to the strength of our communities greatly impacts the health of our people. And down the line, that affects the overall cost of healthcare for all of us.
Dr. Enekwechi likens our approach to a bicycle. “You’ve got a tire, and spokes, and a hub,” she said. “They’re all connected. Healthcare is the hub, the spokes are all the needs that must be met, and the tire only advances the whole bike forward if all the spokes are attached and working.”
While dramatic changes in how healthcare is provided often start when the federal government passes legislation for healthcare systems to follow, Dr. Enekwechi believes solutions need to start at the local level. She says Intermountain’s success at addressing the social determinants of health can easily trickle up and impact the federal level.
We agree wholeheartedly — and that’s why we’re involved in The Alliance for the Determinants of Health, a collaborative effort led by Intermountain that involves city, county, and state agencies as well as other community organizations. Our goal is to improve health by focusing on non-medical factors that affect health, like housing instability, violence at home, food insecurity, and more. While we currently focus on our local communities, we hope to contribute to a national conversation on these issues and be part of an effort for the entire country to help everyone live the healthiest life possible.