A recently published research study suggests that money and love are the primary social determinants of health. While not traditionally considered part of the healthcare system, these factors may play a significant role in influencing our overall well-being.
Social determinants of health are non-medical factors that have an impact on health outcomes, such as income, education, employment, and social context. Interestingly, clinical care only accounts for 10% of mortality rates, with half of the variation in health outcomes at the county level attributed to social determinants of health.
Various metrics and indices have been developed to assess social determinants of health. In 2015, the International Classification of Diseases established standardized diagnosis codes to capture patient information about these determinants. Healthcare providers can use these codes to record such information during clinical encounters, allowing for a better understanding of the prevalence of various social determinants of health.
An analysis of 2.5 billion medical claims from 2020 to 2021 revealed that low income is the most commonly recorded social determinant of health for Medicaid patients, while the most prevalent determinant for commercially insured patients is the relationship with a spouse or partner. In other words, lack of money and love are the primary social determinants of health for these respective patient groups.
It is important to note that these results do not provide direct evidence that these social determinants of health directly impact patients' health status. Other unobservable factors may contribute to low income or partner conflict while also influencing health outcomes. It is also plausible that being unhealthy may lead to low income and partner conflict.
However, among all standardized diagnosis codes for social determinants of health, the lack of money appears to be most closely associated with health. In a better financial situation, the absence of love becomes the main factor.
Ultimately, improving our own primary social determinants of health is in our hands as individuals. While physicians understand the importance of these determinants, the responsibility for addressing them lies with each person. Delegating this responsibility to others risks suboptimal health outcomes and fiscal unaccountability. Instead, it is suggested that subsidies be directed to low-income patients to address their lack of money, while also creating incentives to encourage individual efforts in accumulating wealth and fostering positive relationships.
In conclusion, money and love have been identified as the primary social determinants of health. While the healthcare system may not be able to directly resolve these issues, individuals have the power to improve their own circumstances and potentially contribute to better health outcomes.