How Social Determinants Effect Women's Health and Strategies to Combat Them

Where patients live, work and play significantly effect their overall health. Recognizing how these social determinants of health (SDOH) influence a patient's overall well-being plays an important role in providing holistic care and achieving health equity, especially among women. Due to unequal economic opportunities, reproductive health disparities and power imbalances, many women face daily challenges that can negatively impact their health.  

By recognizing these systemic influences that shape women’s health outcomes, clinicians can tailor strategies to combat disparities perpetuated by social determinants of health. Specifically, by utilizing virtual care methodologies, clinicians can assist women with these struggles, thereby ultimately helping to create a more equitable and inclusive healthcare landscape.

What are social determinants of health (SDOH)?

According to the World Health Organization (WHO), social determinants of health are the conditions people grow, work, live and age in. SDOH are the wider set of forces and systems that shape the conditions of daily life. These factors can account for more than 80 percent of a person’s health status. 

SDOH factors fall into the following general categories: socioeconomic, education, physical environment, community and access to quality healthcare. Within these SDOH factors exist gender-based disparities, uniquely impacting the female population in a couple of ways.

Financial instability

Poverty is one of the largest barriers to positive health outcomes for both men and women. However, the National Women’s Law Center notes that women are at greater risk of poverty than men throughout their lifetime. This is likely due to employment discrimination, caregiving responsibilities and the national wage gap. 

The current wage gap for women is about 82 cents for every one dollar men make - putting women at a greater risk for financial instability. And those who experience financial instability tend to face challenging roadblocks when it comes to accessing healthcare services. They often miss out on essential preventative screenings, prenatal care and reproductive health services. Lower economic status can also lead to a higher likelihood of mental health changes such as anxiety and depression, putting further strain on their health.

Additionally, economic constraints can also limit access to adequate housing and nutritious food, forcing women to choose between healthcare and their everyday needs. A study conducted by Planned Parenthood surveyed women of reproductive age living at or below the federal poverty level and reported that 67% of those women say it's very difficult to pay for the very basics - this includes food, housing and health care. 

Reproductive health

Limited access to educational resources, specifically regarding reproductive health can lead to lower health literacy and reduced awareness of preventative measures. 

Additionally, low levels of health literacy can result in delayed diagnoses of critical reproductive health conditions, leading to poor health outcomes and even mortality. The maternal mortality rate has only risen in recent years, and social determinants like limited access to education, (in addition to other factors like low income and inadequate healthcare), puts sub-populations at a greater risk for pregnancy complications and death.

Power imbalances and violence

Another sociocultural factor that women disproportionately experience and has a major effect on their health is unequal power relationships and violence. The WHO estimates that 30% of women worldwide encounter physical or sexual intimate partner violence in their lifetime. Not only does violence negatively affect a woman's physical health but also her mental, sexual and reproductive health. 

Some risk factors for intimate partner and sexual violence include:

• Lower levels of education

• Community norms that attribute higher status to men and lower status to women

• Limited access to employment opportunities for women

• Gender inequality

Experiencing violence can have long-lasting health consequences, affecting women's overall well-being and quality of life for years after the violence occurred.

Ways clinicians can combat SDOH disparities

Addressing health disparities influenced by SDOH requires targeted interventions and policies that promote gender equity, economic empowerment and access to healthcare and support services. Clinicians play a crucial role in facilitating these interventions and advocating for affirming policies. 

By utilizing virtual care, clinicians can help eliminate geographical barriers and make healthcare more accessible to individuals facing transportation challenges. Telehealth visits also tend to be less expensive than in-person appointments, making care more affordable to women of lower socioeconomic status.

Tailored care

Developing an individualized care plan that targets the specific SDOH factors impacting a patient is a significant step in improving their overall wellbeing. In order to do this, a clinician must first identify these factors. 

An advantage of conducting an assessment virtually is that the clinicians can peek into the patient's home life and enable them to assess some SDOH factors through observation. However, it’s important providers still take time during visits to conduct thorough assessments that include screening questions related to social determinants of health. 

Sample screening questions could include:

• Have you faced any financial challenges recently that impact your ability to meet basic needs or access healthcare services?

• Do you feel adequately informed about health-related topics and resources?

• Are you currently in a safe living environment?

• Do you have a support system of family or friends to rely on in times of need?

It's important to ask any questions in a sensitive and non-judgmental manner, allowing patients to share their experiences and challenges related to social determinants of health openly. Any answers to the screening questions will help reveal areas where additional support and interventions may be necessary.

Care coordination

Once an initial screening is complete, the provider can coordinate additional care or resources a woman may need based on their findings. Telehealth platforms help streamline care coordination, allowing clinicians to easily connect and establish partnerships with community organizations, social workers or community health workers, no matter where they are located. 

By collaborating with other care professionals, clinicians can connect women to resources such as affordable housing programs, food assistance and legal aid services. Working together with community organizations allows the sharing of resources, provides patients with the appropriate services and strengthens the support network available to women.

Expand access to health education 

Providing women with necessary educational resources helps empower them to take their health into their own hands. Virtual care allows clinicians to deliver these education materials directly to women before, during and after visits. Health IT can also deliver these educational resources in multiple languages to accommodate diverse populations and address language barriers. 

Telehealth platforms can also be used to host live educational sessions that focus on different aspects of social determinants of health such as financial literacy, navigating insurance systems and where to access support groups.

Health policy advocacy

However, a care provider alone can only do so much to assist women facing major health disparities while there are systems in place enabling them. This is why clinicians need to advocate for policy changes that address social determinants of health and protect women’s health. Participating in public health initiatives, engaging in community forums and working with policymakers to promote policies that address gender-based disparities, improve access to education, housing, employment opportunities and affordable healthcare services is an essential part of promoting health equity. 

Amplify your impact by joining the OpenLoop network

Clinicians play an important role in creating a more equitable and inclusive healthcare landscape. If you are interested in exploring how virtual care can amplify your impact as a clinician, meet OpenLoop! We thoughtfully pair clinicians with innovative healthcare organizations providing virtual and in-person care in all 50 states. 

Our easy-to-use, HIPAA compliant technology was designed with clinicians top-of-mind for seamless scheduling, patient visits and note charting. With 6,000+ providers already in our clinician network, you can tap into the OpenLoop advantage too with:

• Nationwide connections

• Licensing as a Service

• Sync & async options

• Flexible scheduling

• Competitive pay

• Dedicated provider support

Interested in expanding your reach as a provider? Apply to our clinician network!