America Needs to Focus on Social Determinants of Health

Jennifer Po

Jennifer Po

Guest Contributor | BIO

Conversations around gun control cannot stop at the suburbs of Parkland, Florida.  If this administration really cared for mental health, they would invest in social determinants of health. “A person’s mental health and many common mental disorders are shaped by various social, economic, and physical environments operating at different stages of life. Risk factors for most mental disorders are heavily associated with social inequalities, whereby the greater the inequality the higher the inequality in risk.” 1

The U.S. allocates significantly in health spending but still fails in several measures of health outcomes such as life expectancy and infant mortality.  

In 2017, the U.S. spent $9,237 on health care per person. So, what are we getting for our health care dollars in 2018?  That’s a question we should all be asking. And unfortunately, the answer is, “Not much.”

In theory, we have countless resources at our disposal to save lives and reduce morbidity.  However, we are not always able to use the most effective tools to our capability because of the cost burden to patients. It seems absurd that we can’t choose the treatment or tests that are most effective, but rather settle on a healthcare option that at best is mediocre.  For example, let’s look at social services.  Social services is defined as anything that provides services to assist the overall social well-being of people, and helps individuals become self-sufficient by connecting them with resources such as food assistance, housing assistance, disability assistance, or mental health assistance.  

However, isn’t it ironic how the recent budget proposals are cutting safety net benefits, such as Children Health Insurance Program (CHIP) and Supplemental Nutrition Assistance Program (SNAP)2 and are opting to dump unnecessary money into our military and border security?  All of these proposed cuts will affect poor, sick, and disabled people the most.  Why is it hard to wrap our minds around the social determinants of health? Why don’t we tackle those first?  Other developed countries proportionately spend more on social services than the U.S.  About 80% of individuals’ health is determined by behaviors and the social and environmental conditions in which they live, work, and play.

Let’s turn our attention back to Parkland, Florida.  After a month, where are we now?  Exactly where we were one month and six days ago with another tragic school shooting; this time in Great Mills High School in Lexington Park, Maryland.3 Looks like gun violence is part of our daily environment and leaves our country without any viable comprehensive solutions.

The U.S. has the highest rates of both gun-related deaths and mass-shooting incidents.  In the latest available statistics from the CDC, 33,304 people were killed by firearms in 2014.4  Yet, with all of the research and statistics surrounding gun-related deaths, we still haven’t scratched the surface.  It took the Sandy Hook elementary school shooting in 2012, to get Congress to finally consider restoring funding towards gun violence research.

Gun violence is a social determinant of health.  What can we do to decrease the rate of gun violence?  For starters, approach gun violence as a public health issue by focusing on the underlying health issues and focusing on why individuals would turn to gun violence.

What happened in Parkland, Florida is a symptom of a much deeper problem with our society.  If you look through a holistic lens, each social determinant contributes to a person’s ability to cope with life, be part of a community, and have a deeper connection.  So when one uses social determinants of health as a framework to study this, it’s apparent that the Parkland shooter was dealing with a lack of all supports.  Ask yourself, “How does a person reach a point where they believe pulling a trigger and harming others is their particular answer to their own internal suffering?”

The consequences are not limited to those who were fatally shot and killed; they also affect their families, friends, and communities.  We need to push government to stop gutting public health, public welfare programs, and research.  Doing nothing is no longer an acceptable solution.

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      Jennifer Po

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