Social determinants of health

The five social determinants of health include education, economic stability, health and healthcare, neighborhood and built environment, and social and community context. Health and healthcare factors such as healthcare access and quality healthcare can be barriers to home care and case or care management services (Access to primary care, n.d.). It is important to note that individual with a source of care is more likely to receive recommended preventive and curative services such as blood pressure screenings, flu shots, and cancer screenings.

However, disparities in access to healthcare exist, and many people face challenges that increase the risk of poor health outcomes. Some of the obstacles to healthcare access include language-related barriers, health insurance, disabilities, geographic and transportation-related barriers. Other barriers are inability to take time off work to attend health appointments, and shortage of primary care providers (DeMarco & Healey-Walsh, 2020).

Lack of health insurance decreases primary and preventive care services, and it is associated with poor healthcare outcomes. People that experience reduced access to primary care due to limited availability and provider office hours. Besides, most primary healthcare professionals do not provide health care services during off-work hours. Travel distance and supply of healthcare providers limit people’s ability to get primary care.



In Healthy People 2020, the underlying social determinants introduce a challenge to home healthcare, case and care management. The associated domains consist of “economic stability, education, health and health care, neighborhood and built environment, and social and community context” (“Social determinants of health,” n.d., para. 1).

The first determinant constitutes a menace in view of its potential to define healthcare affordability. Housing instability, poverty, food insecurity, and unemployment contribute to dividing patients of quality and timely service. The second determinant poses a threat due to lack of awareness and comprehension.

While case and care management represent patient-centered delivery systems, they may fail to render care for those who refuse to interact and communicate (DeMarco & Healey-Walsh, 2020). For instance, when the elderly patient prefers alternative medicine over traditional one and stays illiterate on benefits of the latter, the provider is to persuade and communicate for effective treatment and recovery. Lastly, social and community context signify civic participation and social cohesion. It can create barriers as healthcare organizations cannot provide all day long control and communication. Case and care management may guarantee coordinated healthcare interventions, whereas patient’s self-care efforts may either help or worsen their health conditions.