Jan. 29, 2016 – A growing trend of health care providers going beyond simply treating disease to address the root causes of bad health was discussed by University of Houston Law Center Assistant Professor Jessica Mantel in a talk titled, “Providers’ Central Role in Tackling the Social Determinants of Health.” The presentation was part of the University of Houston’s monthly Assistant Professor Excellence Speaker Series.
Mantel said that in general, health care providers have not seen it as their responsibility to address social determinants of health, but that is starting to change. The Affordable Care Act, also known as Obamacare, has implemented incentives that reward the health care community for addressing environmental and social conditions that could negatively impact a patient’s health.
Social determinants of health, such as lacking health insurance, language barriers, the stigma of an illness, or lack of transportation could cause people to delay or forgo health care. Living or working conditions such as pollution, unstable housing, or living in a “food desert” – an area where affordable, healthy food is not widely accessible – are examples of environmental and social factors that could potentially cause physical health issues.
“If patients with asthma keep showing up in an emergency room because there is mold in their apartment, now providers have incentives to do something about that moldy apartment rather than simply treating them in the emergency room and sending them back home,” Mantel said.
Mantel said there has been an emergence of organizations that are more likely to have the expertise and resources to address social determinants of health, but there are limitations.
“Providers can address environmental hazards in a patient’s home, but it might be hard for them to reduce pollution,” Mantel said. “Patients can be educated about the hazards of smoking, but providers don’t have the legal authority to enact bans on smoking in public settings.”
Mantel also explained that there is a shortage of individuals with the specific skills needed to support providers in addressing the social determinants of health, and that institutions of higher learning need to rectify this. Mantel suggested new degree programs and education tracks that emphasize population health management. She also stressed the need to give students in different disciplines – health sciences, social work, public health, law – opportunities to work together in teams, both inside and outside the classroom.
“There are opportunities for UH to be a leader in developing course work that will result in having more people in the labor force with skills in population health management,” Mantel said. “In training health care professionals of tomorrow, it’s also important that doctors and other health care professionals move beyond the biomedical paradigm where they simply diagnose and treat disease without understanding the social determinants of health. As importantly, they have to be able to work in teams with other professions and understand what the others do. There are opportunities in the education arena to help students develop these skills.”