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Social Epidemiology and Your Neighborhood Health Needs

 

By: Stephen Read, PharmD Candidate 2019, Belmont University College of Pharmacy

Adapting Global Health Experiences to Solve Local Healthcare Issues Webinar!

 

Background

Social epidemiology, what does that mean to you?  Responses usually include something along the lines of the study of disease and an association with society.  In actuality, it is the study of the distribution and social determinants of health and disease within populations.  The idea of social epidemiology is nothing new as it was used in several investigations during 19th Century in Europe, including differences in mortality between the poor and affluent in France.  When Germ Theory was introduced, germs were thought to be the only cause of disease and social epidemiology became irrelevant.  In the 20th Century, social epidemiology developed into what it is today with the rise of infectious disease.1  Healthy People 2020 took this science into account when developing strategies and objectives that include social determinants of health.   The government recognized that health starts in the home and the communities surrounding the home.  Social determinants of health represent conditions within the community affecting one’s daily life including culture, education, and job opportunities.2 How is your neighborhood shaped?

Social Determinants of Health in the United States

Disparities are a major problem in the United States, especially health disparities.  Disease states, including diabetes, cardiovascular disease, and respiratory disease, can be linked to one’s access to health services, groceries, education, jobs, residential status, culture, and other social determinants of health.  Studies have shown poor and minority populations are often linked to disadvantaged communities, lack of education, and poor access to healthcare; resulting in a link between one’s zip code and impact on their health.2,3

Are there any toolkits or resources that any healthcare professional can access?  The government has had tools for many years, allowing them to analyze specific communities.  Recently tools like the Neighborhood Atlas, which were used for private or research use are now accessible for the public to view nationwide data.3  The Neighborhood Atlas is a tool that uses the Area Deprivation Index (ADI) to rank neighborhoods on a local, state, or national level based on socioeconomic status.  Health systems and healthcare providers can use this data then to then tailor their services and programs to a specific geographic location.4

Town Charts and the Community Needs Index are other great resources available on the internet.  Town Charts is a great resource that has compiled data from government agencies and past Censuses into one site.  Users can look at information on a country, state, county, city, or zip code level for demographics, housing, local economy, education, and healthcare.  The Community Needs Index was developed by Dignity Health and Truven Health to assist their organizations in gathering information on the socio-economic factors for their communities, allowing them to develop strategies for various healthcare services.  It allows individuals to look at information on a state, county, or city level; however, it differs by looking at the needs of an area based on barriers of income, cultural, education, insurance, and housing.5  These are just several of the tools that are available for healthcare professionals to use for evaluation of services offered. Other options are listed under the resources section below.

Global Health and Use in Local Health

Global health has been a mainstay within many organizations and countries; however, it does not necessarily involve location, but more of a scope (think ‘glocal’ according to Dr. David Steeb, PharmD, MPH, the Director of Global Engagement at the University of North Carolina Eshelman School of Pharmacy). Dr. Steep suggests that in the U.S., we need to begin using the same practices to help improve health outcomes and decrease disparities in our own local communities.   He states that, “our healthcare industry and professionals will need to adapt and change their perception of what services they can provide and where these can be applied,” in Dispensary of Hope’s recent webinar.  He and Stephanie Kiser, RPh, Director of Rural Health & Wellness at the University of North Carolina (UNC) Eshelman School of Pharmacy, discuss the importance of cross cultural communication in serving those in need, along with resiliency in terms of personal and community.  They have developed an interprofessional course, Global and Rural Health: Maximizing Interprofessional Teams to Impact Community Outcomes (GRIT), through UNC Eshelman School of Pharmacy that allows students to reflect on what they have learned on global missions and incorporate those learnings in serving the underserved locally.6  This innovative course is just another way for upcoming healthcare professionals to better understand social determinants of health and how to use their knowledge to serve those in need.

Dispensary of Hope

The Dispensary of Hope has been working on connecting the abundance of surplus medication with need all over the U.S. since its beginning.  Their network of dispensing sites understand the importance of social epidemiology and its value when working with the underserved.  With all the new tools being developed and webinars, our network now has the resources to gain a better perspective of their community and the areas surrounding it.  As Healthy People 2020 states, “improving conditions in which we live, learn, work, and play and the quality of our relationships will create a healthier population, society, and workforce.”2

Please listen to the webinar, “Adapting Global Health Experiences to Solve Local Healthcare Issues,” led by Drs. Steeb and Kiser.  It is available on our Resources page and is a great discussion on identifying transferrable skills obtained through a global health experience and innovative solutions that can be applied to local healthcare issues. 

Key Takeaways

There were several great learnings from the webinar on Global Health that we can apply in our local practice:

  1. Understanding your community –The UNC students serve on county boards of heath to learn about issues.
  2. Looking at the holistic view of the patient – There are multiple factors impacting health and clinical components apply to <25%.
  3. Understanding cultural competency – Cultures respond differently, thus an understanding and individualized approach is key to meeting their needs
  4. Impacting local health – Pharmacists can play a key role in impacting local health issues which align with the efforts of state and local government/community initiatives

Resources

Neighborhood Atlas (https://www.neighborhoodatlas.medicine.wisc.edu/#about-anchor)

Community Need Index (http://cni.chw-interactive.org/

American Fact Finder (https://factfinder.census.gov)

Town Charts (http://towncharts.com/)

County Health Rankings & Roadmaps (http://www.countyhealthrankings.org/rankings/data)

Refer to the 2018 County Health Ranking National Data.

Community Health Needs Assessment (https://www.communitycommons.org/maps-data/)

Create a free login. Click on the “build a report” tab and explore under each of the following categories (demographics, physical environment, social & economic factors, clinical care, health behaviors, health outcomes, etc.) 

Health Metrics (http://www.healthdata.org/us-county-profiles)

CDC (https://www.cdc.gov/gis/public-health-maps.htm)

Google (https://www.google.com/maps)

 

References

  1. Honjo K. Social epidemiology: definition, history, and research examples. Environ Health Prev Med. 2004;September(9):193-199.
  2. Social determinants of health. Healthy People 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health. Updated July 13, 2018. Accessed July 13, 2018.
  3. Kind AJ, and Buckingham WR. Making neighborhood-disadvantage metrics accessible: The neighborhood atlas. The New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMp1802313. Updated June 28, 2018.  Accessed July 13, 2018.
  4. Neighborhood Atlas. Department of Medicine: University of Wisconsin School of Medicine and Public Health. https://www.neighborhoodatlas.medicine.wisc.edu/. Accessed July 30, 2018.
  5. About the CNI. Truven Health Analytics. http://cni.chw-interactive.org/. Updated 2018.  Accessed July 31, 2018.
  6. Steeb D, Kiser S. Adapting Global Health Experiences to Solve Local Healthcare Issues. Webinar presented for Dispensary of Hope; July 31, 2018.