From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.).
Radiology. 2024 Feb;310(2):e223097. doi: 10.1148/radiol.223097.
Social determinants of health (SDOH) are conditions influencing individuals' health based on their environment of birth, living, working, and aging. Addressing SDOH is crucial for promoting health equity and reducing health outcome disparities. For conditions such as stroke and cancer screening where imaging is central to diagnosis and management, access to high-quality medical imaging is necessary. This article applies a previously described structural framework characterizing the impact of SDOH on patients who require imaging for their clinical indications. SDOH factors can be broadly categorized into five sectors: economic stability, education access and quality, neighborhood and built environment, social and community context, and health care access and quality. As patients navigate the health care system, they experience barriers at each step, which are significantly influenced by SDOH factors. Marginalized communities are prone to disparities due to the inability to complete the required diagnostic or screening imaging work-up. This article highlights SDOH that disproportionately affect marginalized communities, using stroke and cancer as examples of disease processes where imaging is needed for care. Potential strategies to mitigate these disparities include dedicating resources for clinical care coordinators, transportation, language assistance, and financial hardship subsidies. Last, various national and international health initiatives are tackling SDOH and fostering health equity.
社会决定因素健康（SDOH）是指基于个体出生、生活、工作和衰老环境影响其健康的条件。解决 SDOH 问题对于促进健康公平和减少健康结果差异至关重要。对于中风和癌症筛查等需要影像学诊断和管理的疾病，获得高质量的医学影像学检查至关重要。本文应用了一个先前描述的结构框架，该框架描述了 SDOH 对需要影像学检查以明确临床诊断的患者的影响。SDOH 因素可大致分为五个领域：经济稳定性、教育机会和质量、邻里和建筑环境、社会和社区环境以及医疗保健可及性和质量。当患者在医疗保健系统中就诊时，他们在每个环节都会遇到障碍，而这些障碍受到 SDOH 因素的极大影响。边缘化社区由于无法完成所需的诊断或筛查影像学检查，容易出现差异。本文以中风和癌症为例，突出了那些不成比例地影响边缘化社区的 SDOH，这些疾病过程需要影像学检查以进行治疗。减轻这些差异的潜在策略包括为临床护理协调员、交通、语言援助和经济困难补贴分配资源。最后，各种国家和国际卫生倡议正在解决 SDOH 问题，促进健康公平。
