What role does a person’s race, education level, social status, zip code, age, and demographics play in achieving good healthcare outcomes? I think it’s easy for anybody to understand that equitable health care means giving every patient the care they need when they need it.

It’s that simple. When you need healthcare, are you able to access it?

Did you know the United States spends $4.1 trillion or $12,530 per person for health care? Yet, according to the AMA and public health researchers and scientists, over 80% of healthcare outcomes are based on social determinants linked to a person’s demographics.

According to the Institute of Medicine reports, if we put health equity and social determinants at the center of medical practices, we can significantly make a difference.

Table 1.

So, what are the social determinants of health?

Social determinants are all around us. Outside influences determine the ease, peace of mind, and quality of our life—social determinants Things like the quality and accessibility of education, healthcare, economic stability, and more.

When we say economic stability, we’re talking about whether you can get ANY job and a job that pays a livable wage. Jobs that pay a livable wage provide mental and physical wellness that causes stress connected to chronic illness.

Reducing other negative factors that are systemic issues in our society, such as illiteracy, discrimination, incarceration, environmental toxins, and obesity is achievable.

With these factors, we have metrics that determine that people who have a higher incidence of these factors in their life are more likely to be sick. It’s important to note that there’s a difference between being sick chronically vs. episodic sickness. Episodic sicknesses include getting a cold, breaking an arm, bursting your appendix, etc. Those things get fixed relatively quickly, and the medical community is exceptional at handling episodic illnesses. Chronic illnesses like diabetes, COPD, asthma, bipolar mood disorders, Crohn’s disease, Hypertension, or Eczema need ongoing management.

What will it take to shift the tides on healthcare equity in America?


According to a Gallup analysis of data from the U.S. Department of Education, about 54% of adults have a literacy rate at the sixth grade. So how will we ever hope to reduce the cost of healthcare if we don’t address how we educate healthcare professionals and the general public?

The complexities of caring for their body, and knowing the difference between chronic and episodic management, requires an educated and collaborative response. Living well means everyone is responsible and accountable for knowing their body and how we respond to social and environmental conditioning.

What can the healthcare industry do to improve healthcare inequities?

Insurance plans, employers, and healthcare providers can start with the three specific things.

  1. Knowledge provides the power to make a difference. Go work at a community health clinic. That’s an easy way to learn, seek to understand, and engage the community to understand how social determinants impact the health of their patients. Plus, your knowledge is desperately needed.
  2. It’s a big problem; so convene a party. Okay, I took that from a chapter in my book. But imagine, at the state level, parties coming together and convening with a genuine intention to see how to focus on outcomes-based measurements. I know it may be hard to believe this could happen. However, Imagine a diverse, committed group of individuals in a room seeking to eliminate healthcare inequities in their communities. Egos left at the door open both incremental and innovative changes to address the issues.
  3. Lastly, change how we train (educate) healthcare providers, especially physicians and support practitioners. The AMA has known since the early 2000’s that this is a problem. They developed strategies to minimize, if not eliminate, the level of insensitive, discriminatory, and hostile workplaces hospitals and medical practices can become.

There’s no easy solution. It will require all of us to seriously consider all sides to ensure that everyone in America has access to the level of healthcare and resources they need to thrive.