Dr Rachel Gold: Cultural Shift Still Needed in Healthcare to Address Social Determinants of Health

August 28, 2018

In some ways, healthcare is ready to take on addressing social determinants of health, but there still needs to be a cultural shift in mindset in a lot of ways, said Rachel Gold, PhD, MPH, investigator at the Kaiser Permanente Northwest Center for Health Research and lead research scientist at OCHIN.

In some ways, healthcare is ready to take on addressing social determinants of health, but there still needs to be a cultural shift in mindset in a lot of ways, said Rachel Gold, PhD, MPH, investigator at the Kaiser Permanente Northwest Center for Health Research and lead research scientist at OCHIN.

Transcription:

In general, how ready is healthcare to get involved with addressing social determinants of health?

I’d say the health care system is, in some ways, ready to take this on, and, in some ways, not. Again, my focus is on community health centers. I think pediatrics, primary care, and family medicine, in particular, are specialties in those areas of care that understand and know that social determinants affect health. That’s obvious to folks that are dealing with patients, especially, in primary care, family medicine, and pediatrics. So, I think they’re ready in that they understand the stuff affects our patients’ health.

I think the challenge is, you get folks who are trained to be clinical care providers being asked now to also be, in some ways, social workers, and, in some ways, make referrals to community agencies. Then, there’s these staffing issues involved with, do you have to have a social worker on staff? Can you afford to have a social worker on staff? Are they going to be there all the time? How do you get patients? How do you help support healthcare systems? Take that next step beyond sort of knowing that a patient’s needs are affecting their health, or maybe trying to address them in a non-systematic way to facilitate them helping with community referrals in a systematic way.

I think it involves a certain amount of a cultural shift for healthcare staff to think about, “oh now we’re addressing that too? Now we have to take that on?” I do think folks in the medical system are ready in some levels, and not in others, because of that cultural shift that’s going to be involved with making that referral. That’s really an issue around acculturating healthcare providers to think this is also something they need to take on.