HEALTH

Social Determinants and Lupus Care in the Black Community

When it comes to systemic lupus erythematosus (SLE) and social determinants of health (SDoH), it is clear that these issues go hand in hand, especially for the Black community. Dr. Sam Lim, chief of rheumatology at Grady Health System, and his team studied this association in a study presented at the American College of Rheumatology, and their findings were striking.

“Nearly 80% of patients, mostly black women, tested positive for at least one social risk factor,” Dr. Lim said.

This includes financial stress (up to 72%), food insecurity (51%), and housing and utility issues (35%). These are not just numbers. They represent real barriers to accessing care and achieving better health outcomes.

BOOM: Can you start by summarizing the main findings of your study, particularly highlighting specific data that apply to the Black community?

Dr. Lim: Nearly 80% of patients, most of them black women, tested positive for at least one social risk factor. Common challenges included financial stress (up to 72%), food insecurity (up to 51%), and housing and utilities (up to 35%). Importantly, 91% of patients expressed comfort discussing social risk factors, highlighting the value of incorporating SDoH screening into routine care.

BHM: Can you explain what social determinants of health (SDoH) are and why they are important when considering health outcomes for the Black community?

Dr Lim: Social determinants of health refer to the conditions in which individuals are born, grow, live, work and age. These factors, including income, education, housing, access to health care, and experiences of discrimination, account for 30% to 55% of health outcomes. In the Black community, negative SDoH, such as poverty and housing instability, is associated with increased disease activity and poorer health outcomes. Systemic racism and discrimination exacerbate these effects by increasing stress and reducing access to resources.

We have chosen for you:  How To Say Turmeric

BHM: How does SDoH specifically affect black patients with SLE, and what has your study revealed about these effects?

Dr. Lim: Black people with SLE face negative symptoms of SLE, such as poverty, food insecurity, and inadequate housing, which increases the risk of SLE and associated comorbidities.

Discrimination is significantly associated with increased lupus activity and organ damage in black women.

Despite these challenges, patients were willing to engage with their health care providers to address these barriers. This underscores the need for systemic changes to address the impact of SDoH on Black people with SLE.

BHM: How important are trust and cultural competency in conducting these performances within the black community?

Dr Lim: Trust and cultural competence are crucial. Almost all patients were comfortable answering these questions and appreciated discussing their social needs. Building trust involves recognizing historical and persistent inequalities in health care and engaging in culturally competent care.

When patients view healthcare providers as compassionate and nonjudgmental, they are more likely to share sensitive information, which is necessary to effectively address SDoH.

BHM: How do barriers such as transportation, financial constraints, and limited health care resources impact Black patients with SLE, and what strategies can help address these issues?

Dr. Lim: Barriers such as transportation difficulties, financial constraints, and limited health care resources often lead to missed appointments, delayed diagnosis, and interrupted treatment. To address these barriers, community initiatives and systemic changes are needed. Mobile clinics, telehealth services, and financial assistance programs can help. Supporting healthcare navigation and cultural competency among providers is also critical. Addressing these barriers requires a collaborative approach that combines comprehensive health care reform, community-based solutions, and patient-centered support.

Bahm: The study emphasized the importance of institutional leadership in addressing health inequalities. Why is it important for healthcare organizations to prioritize SDoH, especially for marginalized communities?

Dr. Lim: Healthcare organizations have a unique ability to identify, address and mitigate structural and social barriers that impact patient outcomes. By prioritizing SDoH, organizations can improve individual health outcomes and promote equity within the broader community. Institutional leadership sets the tone for cultural competency and trust building, helping to rebuild trust and demonstrate a commitment to equitable care. This is vital for the management of complex diseases such as SLE. Institutional efforts to address SDoH can also influence policy and funding priorities at the local, state, and national levels.

BHM: Given that the SDoH screening tool has been tested and shown to cause minimal disruption to clinical workflow, what steps are needed to make it standard healthcare practice, and why should it be implemented at scale?

Dr. Lim: Integrating the screening tool into electronic health record systems allows for seamless integration into clinical workflow. Training healthcare staff on the use of the tool and the importance of SDoH is essential. Institutional leadership and financing mechanisms are also critical to achieving long-term sustainability. Reimbursement models and partnerships with community-based organizations can support the implementation of SDoH checks.

BHM: What are the best strategies for healthcare providers to engage patients in discussions about social determinants of health?

Dr. Lim: Health care providers must build trust through participatory listening, taking a non-judgmental approach, and following through in addressing concerns.

Cultural competence is critical, and providers must respect the cultural, social, and personal contexts that shape patient experiences. Using inclusive language and open-ended questions helps create a welcoming environment.

Providers should also be equipped to connect patients to community resources and social services.

BHM: What long-term impacts do you anticipate from incorporating SDoH screening into routine care, especially for marginalized communities?

Dr. Lim: Treating SDoH early can prevent chronic disease exacerbations, reduce hospitalizations, and improve quality of life.

Incorporating SDoH screenings can also enhance trust between patients and providers and make healthcare more proactive and preventative.

Over time, this could reshape health care delivery by shifting resources toward upstream solutions that keep patients healthy.

Focusing on social determinants of health in lupus care is not just about ticking boxes. It's about understanding the real-life challenges that patients face. Dr. Lim and his team's study is a call for healthcare providers to work deeper and foster authentic connections with their patients. By acknowledging these social factors, we can create a more compassionate and equitable healthcare system that truly sees and supports every individual.



Source link

Related Articles

Leave a Reply

Back to top button