Social Determinants of Health—Using a Holistic Approach to Cancer Care

Excerpt

The recent emphasis on social determinants of health (SODH) has shifted to the forefront of conversations on health inequities among leading health organizations worldwide. The World Health Organization (WHO), Center for Disease Control (CDC), Robert Wood Johnson, National Association of Medicine (NAM), and National League for Nursing (NLN), for example, have position statements that place emphasis on SDOH as an important determinant in health outcomes. A common theme apparent from these position statements is that SDOH are “the conditions in which people are born, grow, live, work and age.” The WHO further delineates SDOH as “those conditions that influence a person’s opportunities to be healthy and their risk of illness and life expectancy.” A related concept, also the topic of discussion, is the social inequities in health, which are the unfair and unavoidable differences in individual health status that exists as a result of the uneven distribution of social determinants (WHO). These and other conceptualizations of SDOH are widely accepted among healthcare scholars and practitioners and have been instrumental in drawing much needed attention to the inequities that contribute to health disparities particularly among underrepresented racial/minority groups. Scholars have addressed SDOH using a fragmented approach—i.e., poverty, social policies, food deserts, accessible healthcare, and unsafe neighborhoods. However, I propose that SDOH should be viewed as interwoven concepts of a whole, which at any given time, an individual’s health outcomes are influenced by social, cultural, environmental, and political conditions, an interwoven, dynamic collective of conditions similar to a woven bamboo basket or woolen broadcloth. In other words, similar to SDOH, that woven bamboo basket or woolen broadcloth represents a whole of conditions influencing health outcomes and the weakening of one strand of bamboo or thread in that broadcloth affects the whole individual. …