Physician Assessment of Social Determinants of Health: A Necessary Component in Improving Care of Patients

Abstract

The importance of building a therapeutic relationship between a physician and a patient is taught early on in a medical student's training, specifically through the practice of obtaining a patient history. This process consists of gathering information in four main categories: the history of the present illness, personal social history, past medical history, and family history. Each piece of information obtained within these categories is vital in ensuring a patient receives appropriate and effective care. Specifically, a social history consists of asking about a patient's relationship status, support system, home environment, interests, exercise, nutritional habits, substance use, and sexual history. To complete a successful and full social history, one should try to address the social determinants of health. As per the Government of Canada’s website, social determinants of health “refer to a specific group of social and economic factors within the broader determinants of health. These relate to an individual’s place in society such as income, education or employment” [1]. Consequently, a critical component of a complete social history interview should be investigating a patients socioeconomic status. Low socioeconomic status (LSES) has been found to play a role in incidence and susceptibility to a variety of health conditions. As such, I believe that screening for and asking questions pertaining to the socioeconomic status of a patient should be considered a vital and essential component of every patient assessment.