Re-Examining the Social Determinants of Health

Posted on June 22, 2021 by Katie Bryski

The COVID-19 pandemic has concretely demonstrated the impact that social factors can have on health and health equity. Health inequities occur when a person experiences poorer outcomes and quality of care based on who they are, where they live or what they have. The new on InfoCentral will explore how to incorporate social determinants of health (SDOH) concepts into digital health systems.

Recently, the group’s leaders joined to explore SDOH in more depth, and to discuss the new working group. Marcy Antonio is a PhD candidate at the University of Victoria, and Dr. Annalijn Conklin is Assistant Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia. We were also joined by Infoway’s Waldo Beauséjour.  

The social determinants of health have often been defined as individual characteristics, such as gender, age and postal code. However, this understanding is evolving. “I see it much broader than that,” explains Marcy Antonio. “I actually see it more at a structural level, where it’s the systems that are creating these inequities.” These societal systems create overlapping contexts that Dr. Conklin likens to an onion. “You've got that individual…but they're embedded within a family structure. They're embedded within a community setting.” These settings expand to political and economic systems, and even to the physical environment itself.

More subjective measurements can also provide important insights. “Do we collect information on trust?” Beauséjour asks. “Do we collect information on how people feel when they interact with their health care providers?” While he notes that this can be a difficult indicator to measure, some studies — in Canada and internationally — have begun including more measurements relating to patient satisfaction and perceptions of the health system.

Clearly, there is a substantial amount of data to consider. But how is it currently captured in digital health systems? “Not very well,” Dr. Conklin says. Information may exist in different places — the census and tax forms, for instance — but it is rarely linked to health system datasets. Moreover, because SDOH data can be sensitive, it’s important to ensure its safe collection and appropriate use.

Enter the Social Determinants of Health Working Group. Meeting monthly, the group seeks to develop guiding principles on how to proceed in the implementation of SDOH concepts into digital health systems. As Antonio explains, “[We’re looking at] how we can do culturally safe practices around the collection, use and sharing of the social determinants of health data.”

To contribute to the conversation, visit the Social Determinants of Health Working Group. Meetings are held on the first Wednesday of every month, from 12-1 p.m. ET/9-10 a.m. PT. Come prepared for interactive discussions and breakout rooms. You can get your ideas flowing by listening to our full SDOH episode on the Digital Health InfoCast, and by reading the Digital Health Equity Analysis.

Katie Bryski serves as Content Administrator for Canada Health Infoway. With nearly ten years of podcasting experience, she also produces Infoway’s podcast, the Digital Health InfoCast. She is particularly interested in how digital health relates to intersectionality.