Page 7 - Adelante Magazine April 2021

BY: DANIEL PEARCE, D.O., FACOI, AAHIVMS
A
ASK THE
DOCTOR
Photo by: Li Sun from Pexels

THE 5 DETERMINANTS OF HEALTH

I attended the major HIV meeting of the year your problems till they become life-threatening. then it is hard to get ahead. Are you injured or
recently and one of the main thrusts of each The system seems set up to fail. Do you under- do you have a disability that makes it hard to
meeting is disparity: Why is one group winning stand the complexities of the health care find and keep a job?
and another group is losing—money, attention, system and keep running into dead ends? Is
priority. You’ve heard of systemic racisim (the there access to good mental health care? 5. Neighborhood and Built Environment
system is set up to discriminate against some), There are delays in getting insurance, e.g., Is there more crime, traffic, and pollution in your
that there is no conscious racism, it is when you move to a different county. neighborhood. Is good housing affordable? Is
automatic. “That’s just the way it is, we’re not there healthy food available at markets near
racist.” Here is a deeper, more detailed expla- 2. Education Access and Quality you for a good price? Do people ride bikes in
nation of why things are this way. I hope you People with higher education usually live bike lanes and others stroll on the sidewalk.
and I can do many things to counteract this and longer and have higher paying jobs.Were you Are there problems playing in the park? Is the
correct it. (or your children) sent to schools and park too far away? Is there childcare available?
preschools that were poorly maintained with Are prices higher in your neighborhood.The
very large classes and overworked teachers, business people typically locate the harmful
SOCIAL DETERMINANTS OF HEALTH with a poor library, poor supervision of recess companies in neighborhoods they don’t live in
AFFECT YOU? times so that violence happened at times? The stress of a bad neighborhood can cause
The five SDOH are conditions in the places Were your schools far away. Were there few poor school performance..
where people live, learn, work, and play that after-school sports and programs available so
affect a wide range of health and quality-of life- your learning was not cultivated? Did you There was an experiment where some people
risks and outcomes. If you have it easy in the 5 master English and your studies so that you were given 50% more play money in monopoly
areas below then they and their children and graduated and got into college if you desired? and, with this advantage, they won the games.
grandchildren have it much easier in life, there What barriers were against you to reach your When asked how they won, they said it was
is more money, less mental illness; they don’t full potential? Did your relatives read to you skill, not the extra money/advantage at the
understand why someone else can’t be and encourage you in your studies? beginning.
successful. Some of these conditions are as
disabling as having a major illness, such as 3. Social and Community Context I’m not saying money is the source of
diabetes or a major car accident. Is your family or community full of friction and happiness, but a basic amount helps level the
suspicion? Is there racial discrimination or field—eliminates the disadvantage.
1. Healthcare Access and Quality violence in your neighborhood. Are many of
Do you live far from clinics, have insurance those from your neighborhood in prison or Keep those questions coming and be safe!
problems, or speak a different language than recently released. Are single-parent familes,
the clinic? Is the healthcare the clinic delivers teen pregnancy, and latch-key kids the norm?
low quality where they rush you through and dpearce@western.edu
don’t seem to be helpful? For minor things they 4. Economic Stablitiy Daniel Pearce, D.O., FACOI, AAHIVMS
don’t have an appointment available and Did your parents buy a house and save for Clinical Associate Professor of Medicine, Loma
suggest you go to the Emergency Department retirement? Did your relatives pass some of Linda University School of Medicine Adjunct
where there are a crowd of people waiting 6 the wealth to you after they died? Did Professor of Internal Medicine and HIV, Touro
University California College of Osteopathic
hours for care? The Emergency Department employers respect you and hire or promote you Medicine and Midwestern University Arizona
is set up to take care of life-threatening for your skills? Is job loss an issue? Do you College of Osteopathic Medicine HIV, Hepatitis
problems, not so much the other long list of have to prioritize the bills and buy food over B,C, Transgender, Suboxone Specialist, Borrego
Health (Riverside, San Bernardino, San Jacinto)
problems, so they refer you back to your clinic rent? Do you borrow money to make ends Member, Coachella Valley Clinical Research
which is not that helpful. You feel caught up in meet. Do you get evicted due to non-payment. Initiative
a cycle where no one cares and you ignore If you are moving from job to job with big gaps,
REFERENCES: Medscape®
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