Perez Felipe P, Perez Carmen A, Chumbiauca Magali N
Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
School of Social Work, Indiana University, Indianapolis, IN, USA.
J Biomed Sci Eng. 2022 Nov;15(11):261-268. doi: 10.4236/jbise.2022.1511023. Epub 2022 Nov 2.
In this paper, we review the social determinants of health in older adults and their complex interrelationship with medical diseases. Also, we provide recommendations to address these determinants in the integrated healthcare plan. The social determinants in older adults and its influence in health outcomes have been studied for decades. There is solid evidence for the interrelationship between social factors and the health of individuals and populations; however, these studies are unable to define their complex interrelatedness. Health is quite variable and depends on multiple biological and social factors such as genetics, country of origin, migrant status, etc. On the other hand, health status can affect social factors such as job or education. Addressing social determinants of health in the integrated healthcare plan is important for improving health outcomes and decreasing existing disparities in older adult health. We recommend a person-centered approach in which individualized interventions should be adopted by organizations to improve the health status of older adults at the national and global level. Some of our practical recommendations to better address the social determinants of health in clinical practice are EHR documentation strategies, screening tools, and the development of linkages to the world outside of the clinic and health system, including social services, community activities, collaborative work, and roles for insurance companies.
在本文中,我们回顾了老年人健康的社会决定因素及其与医学疾病的复杂相互关系。此外,我们在综合医疗保健计划中针对这些决定因素提供了建议。老年人的社会决定因素及其对健康结果的影响已经研究了数十年。社会因素与个体及人群健康之间的相互关系有确凿证据;然而,这些研究无法界定它们之间复杂的相互关联性。健康差异很大,取决于多种生物学和社会因素,如遗传学、原籍国、移民身份等。另一方面,健康状况会影响工作或教育等社会因素。在综合医疗保健计划中解决健康的社会决定因素对于改善健康结果和减少老年人健康方面现有的差距很重要。我们建议采用以人为本的方法,各组织应在国家和全球层面采取个性化干预措施来改善老年人的健康状况。我们在临床实践中更好地解决健康社会决定因素的一些实际建议包括电子健康记录文档策略、筛查工具,以及建立与诊所和卫生系统之外的外部世界的联系,包括社会服务、社区活动、合作工作以及保险公司的作用。