Beyond the Doctor's Office: Why Your Health and Your Community's Rest on Social Factors

Determining a true measure of health goes way beyond doctor appointments, annual checkups and how you happen to feel on any given day. Economic status, income level, environmental conditions, lifestyle behaviors — these and other variables all factor in to paint the complete picture, both for individuals and for communities as a whole.

“Social determinants of health are all the conditions in which a person lives, works and plays,” says Melanie Miller, manager of Population Health Coordination at the Greater Baltimore Medical Center.

According to National Association of Counties research, social and economic factors account for 40% of a person’s overall health makeup, with lifestyle behaviors making up another 40%.

Here are some of the most significant social health determinants, and how GBMC is working to bridge the gaps.

Strains on Financial Resources

“This is the biggest hurdle our patients are experiencing,” Miller says. In the event patients can’t afford to pay for their medications, housing, insurance and other cost-of-living expenses, GBMC care coordinators and managers look for ways to help find lower-cost alternatives and connect them to social services and agencies that may be able to provide assistance.

Food Insecurity

GBMC screenings reveal that a significant number of patients don't have access to — or can’t afford — healthy food. In these cases, care coordinators can put patients in touch with food pantries, Meals on Wheels and Hungry Harvest. GBMC also partners with SNAP to sell fresh local produce at discounted prices at an on-campus community market the first and third Friday afternoons of each month.

Transportation

Patients may have trouble getting to and from doctor appointments because they can’t drive or have lost their licenses and are dependent on family members, friends or public transportation. GBMC has teamed up with CountyRide and other ridesharing programs for medical transportation and assists patients with completing the paperwork needed to sign up.

Social Isolation

Care coordinators can recommend senior centers, agencies, affordable outlets and activities for elderly patients and others who feel lonely or disconnected from the community.

Health Behaviors

GBMC primary care providers work closely with their patients to screen for potentially unhealthy behaviors with a focus on preventive care, solutions and results.

Domestic Violence

“If a patient screens positive for intimate partner violence, we try not to let them leave the office without an intervention,” Miller says. GBMC’s Sexual Assault Forensic Examination and Domestic Violence (SAFE and DV) team provides confidential assistance to help patients in need locate resources and navigate appropriate next steps.