How social determinants of health apply to clinical practice

Social determinants of health, as defined by the World Health Organization (WHO), are the ‘non-medical factors that influence health outcomes’ and that have an important influence on health inequities.
 
‘In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health,’ the WHO states.
 
Australia is no exception.
 
The Australian Institute of Health and Welfare continues to report that people in lower socioeconomic groups are at greater risk of poor health, have higher rates of chronic conditions, disability and death, and live shorter lives than people from higher socioeconomic groups.
 
Later this month, GP22 attendees will have the opportunity to gain a better understanding of how primary healthcare providers can influence social determinants and impact population health at the conference’s second plenary, ‘Social and commercial determinants of health and their implications for general practitioners’.
 
Professor Fran Baum, Director at Stretton Health Equity at the University of Adelaide, is presenting the plenary and hopes to provide GPs with solid take away messages to apply to their practice.
 
‘[GPs can gain] a better understanding of the upstream determinants of health and how they impact on people’s health,’ she told newsGP.
 
‘I will also discuss the idea of social health tools to use in general practice, why advising patients to change their lifestyles may not be effective, and consideration of why adopting a strong focus on prevention is so difficult in the Australian health system.’
 
According to Professor Baum, the presentation will examine the distribution of power and resources in a society and how it influences daily living conditions – including employment, access to health services, housing and quality of urban environments. 
 
It will also look at the influence of commercial determinants of health, such as the food and alcohol industries.
 
‘This topic is important to GPs because these determinants “get under people’s skin” and show up in consulting rooms,’ Professor Baum said.
 
‘Understanding them also gets beyond a focus on lifestyle – this is important because telling people to change their lifestyles when they have these determinants stacked against them may make patients feel worse because they feel powerless to make changes given the structural issues they face.’
 
Preventive healthcare and providing lifestyle advice in a holistic and non-judgemental way are some of the central roles embedded in GPs’ practice.
 
The GP22 presentation will also examine consideration of a social health tool as a means of collecting information, and the value of community health centres in taking these determinants in to account.
 
Professor Baum, who is the recent co-Chair of the Global Steering Council of the People’s Health Movement, this year began a National Health and Medical Research Council Investigator Fellowship for her research project, ‘Restoring the Fair Go: Which policies and practices are likely to reverse growing health inequities post-COVID-19’.
 
When attending GP22, what is Professor Baum most looking forward to?
 
‘Hearing perspectives from GPs at a time when the profession is facing many problems, and health systems are perceived to be in crisis,’ she said.
 
‘And sharing my ideas about the importance of understanding the impact of the social and commercial determinants of health to clinical practice.’
 
The second plenary session at GP22 is from 9.00 – 10.00 am, Saturday 26 November, and will be available for digital attendees after the in-person conference has finished. Full program details are available on the GP22 website.
 
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GP22 lifestyle factors social determinants of health socioeconomic status