Top Things to Know: Social Determinants of Health in the Care of Patients With Heart Failure
Published: March 30, 2020
- Heart failure (HF) is a clinical syndrome that affects over 6.5 million Americans, with an estimated 550,000 new cases diagnosed each year.
- Social determinants of health (SDOH) refers to the circumstances in which people are born, grow up, live, work, and age, and the systems in place to offer health care and services to a community, and influences a person’s wellbeing and how they perceive and experience care in the health system, community and home.
- The complexity of HF management is compounded by the number of patients who experience adverse downstream effects of the SDOH.
- This statement addresses how specific SDOH, including socioeconomic position, access to care, environment, race, ethnicity, gender, age, social support and health literacy, and interventions affects the care of HF patients.
- Consideration of theoretical models to explain the impact of SDOH will help clinicians to address SDOH and seek opportunities and resources to help patients with HF manage their care.
- The scope and breadth of SDOH requires a commitment to educating healthcare providers and utilizing interprofessional collaborative practice teams to implement interventions to address SDOH issues in clinical practice.
- Assessing SDOH in clinical practice can be achieved by using standardized screening and tools designed to evaluate the extent of disadvantage and vulnerability from the community to the individual patient. Examples include the Social Deprivation Index (SDI) and Functional Health Patterns tool.
- Enhancing the SDOH competency of HF clinicians, educators and researchers includes the use of assessment tools, development of systems to facilitate data management, collaboration with community partners to identify the SDOH needs of HF patients, and development of interprofessional collaborative practice models.
- The lengthy and demanding continuum of care for patients with HF can benefit from a care management system that incorporates a team-based approach, including ongoing assessment of SDOH.
- Clinicians and researchers should focus their efforts to develop a deeper understanding of the impact of SDOH on HF care, design and implement interprofessional care teams to facilitate self-care and navigation across the health care system, and increase research to determine which interventions are most beneficial to improve health outcomes.
Citation
White-Williams C, Rossi LP, Bittner VA, Driscoll A, Durant RW, Granger BB, Graven LJ, Kitko L, Newlin K, Shirey M; on behalf of the American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Epidemiology and Prevention. Addressing social determinants of health in the care of patients with heart failure: a scientific statement from the American Heart Association [published online ahead of print April 30, 2020]. Circulation. doi: 10.1161/CIR.0000000000000767.