Social Determinants of Health

Question 1

Define Social determinants of Health

Answer 1

Social Determinants of health refer to conditions in which people are born, grow,live, work and age.

Question 2

What are different social determinants of health

Answer 2

1. Socioeconomic status
2. Education
3. Neighborhood
4. employment
5. Social/support
6. Access to healthcare

Question 3

How to address social determinants of health within the healthcare system?

Answer 3

1. Multiplayer contracts, Medicaid initiatives, Managed care plans.
2. Medicaid delivery systems and payment reforms. Broader services in the Affordable Care Act, housing and employment support. Deliver System Reform Incentive payments.

Question 4

How can we address social determinants of health outside of the healthcare system

Answer 4

Shape policies in non-health sectors to promote health and equity
“Health in all policies”
Place-based initiatives in communities w/ poor health outcomes

Question 5

Maciosek and Preventative Services

Answer 5

Maciosek looked at the degree which preventative services are a good investment.

Question 6

What were the two types of preventative services that Maciosek addressed.

Answer 6

He looked at Primary and Secondary Preventative services to asymptomatic people (tobacco cessation screening, alcohol abuse screening, daily aspirin use)

Question 7

What was Macioseks Approach to Preventative Health Care?

Answer 7

1. They Calculated total life years that could be saved per 10,000 people in the US population in 2006 if each service was delivered as recommended.
2. Calculated costs and savings per person-year.
3. Multiplied costs by size of target population.
4. Multiplied life years and medical savings by same population.
5. Compared costs to benefits
6. Calculated total costs/savings if: the total package of services was provided to 90% of the recommended population, marginal costs and savings to go from existing rates to 90%
7. Calculated life years if the population had received the recommended preventative services

Question 8

List one limitation of the Preventative services study by Maciosek

Answer 8

They don’t discount future savings back to the present

Question 9

Findings of Frank (2008)

Answer 9

Frank looked at the increasing demand that clinical choices be based on evidence. Frank argued that it was premature for Rosenheck to reject second generation drugs

Question 10

what were the two central questions that Frank (2008) asked?

Answer 10

1. Does CATIE offer sufficient evidence about effectiveness and cost effectiveness to provide a strong platform for making choices?
2. What might decision makers sensibly consider in making choices about the rationing of second-generation antipsychotics?

Question 11

What was a significant limitation of Franks study (2008)

Answer 11

about 75% of patients ended the study on different medication than initially assigned