Social Determinants of health graph

Social Determinants of Health 
Togetherness – Fight Loneliness


Social Determinants of Health 

Social determinants of health are the conditions in which people are born, grow, live, work and age that shape health

  • Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, loneliness  and social support networks, as well as access to health care. Addressing social determinants of health is important for improving health and reducing longstanding disparities in health and health care.  Many Medicare Advantage Plans are including a lot of “extras” to help..
  • Fundamental disadvantages like poverty, hunger and homelessness typically coexist with a lack of transportation and information about the healthcare system. As much as 80 percent of patients’ health is affected by these factors. Consider the following statistics:
    • Twenty-six percent of U.S. adults said that they had experienced emotional distress in the past year that was difficult to cope with alone.
    • U.S. adults were more likely than adults in all other countries to report that they were “always” or “usually” worried about having enough money to buy nutritious meals and to pay their rent or mortgage.
    • U.S. adults were the most likely to report financial barriers to healthcare, and 33 percent reported that they have had a cost-related access problem in the past year.
  • Managed care plans (HMO’s), Medi Cal – Medicaid and providers also are engaged in activities to identify and address social needs. 
  • There are many problems to address social determinants of health.  While these social determinants of health typically fall outside the scope of most health plans, effective care cannot be delivered while ignoring them. 
  • It’s not just having Insurance for when you are ill, but preventing illness by creating a better living environment   
  • Insurance companies can offer immediate assistance by transferring members to a care manager or social worker.  Doing so, can reduce healthcare costs by 10 percent or $2,443 annually per member 
      • Social Determinants of Health:  The Impact on Members, Health Outcomes and the Bottom Line 11 page brochure Modern Health Care
      • Scroll down for loneliness, graphs, resources, links & bibliography
    • Orange County forms task force to address health-equity issues READ MORE  LA TIMES 4.4.2022 
  • Advocates are pushing for a health equity and racial justice fund in California. Here’s what it would do
  • Webinar on loneliness
  • Medicare Advantage Benefit Design
  • High-Deductible Health Plans Make Income Inequality Worse
  • california health

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Introduction #Loneliness Benefits and Advantages of Togetherness 

Loneliness is a common emotional distress syndrome with a high risk factor for early mortality and a broad variety of physical health and psychiatric issues, it still gets little attention in medical training or in health care more generally,”  Business

“Some experts think that when you feel isolated you’re more likely to feel unsafe and perceive that the world is more threatening in some way, which leads to stress and anxiety and low self-esteem, and those can create health issues. Others believe that those who are socially isolated from others are having a harder time taking care of themselves regulating themselves. They’re not guided by social norms or cues and may engage in more unhealthy behaviors like eating poorly, substance abuse, smoking, and then others may argue that loneliness is tied to other physical issues like sleep disturbance or increased cortisol, which creates and exacerbates health issues.”  Often, she adds, they face financial problems.

“Forty percent of high-need isolated adults have incomes below $15,000 a year, and 80 percent of those people say they worry about having enough money to pay bills or afford healthy food — a rate more than double that of the total sample of adults. And even more concerning is that because of this financial hardship they’re more likely, three times more likely than other adults, to skip doses or not fill their medications.”

The United Kingdom appointed a Minister for Loneliness to address the finding that nine million British people often or always feel lonely.

CareMore Health, has a Togetherness Program. It’s a comprehensive initiative aimed at identifying and intervening in the loneliness among its senior patients;  Often, the most common pathology seem is not heart disease or diabetes; but loneliness.”

Social connection significantly affects health. When you believe that you have people in your life who care about you, and you interact with them regularly, you are better off. For instance, you may be less likely to catch a cold, have a stroke or heart disease, slip into early cognitive decline and developdepression. You may even be more likely to overcome socioeconomic disadvantages, recover quickly from illness and live longer.

Among Caremore’s  efforts, they screen for loneliness during appointments, have regular phone conversations and home visits with at-risk senior patients to show they care, and provide informal social hubs at their clinics to foster connection.    

The seclusion that comes with aging in America is more than just unfortunate; it’s a health problem that CareMore CEO Sachin H. Jain, MD, MBA, FACP, says affects 43% of seniors over age 65. A study in 2016 showed a direct connection between the size of one’s social network and health, and CareMore cites research that compares extreme isolation to smoking 15 cigarettes a day.

Connect seniors with local resources, including CareMore gyms at existing facilities. In some cases, home visits are needed.



Social determinants of health are the conditions in which people are born, grow, live, work and age. They include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care

Social Determinants of health graph


Income vs Health Status  

income vs health status


Factors impacting health can be presented through an upstream/downstream model – with upstream inequities that can create unequal living conditions. These unequal conditions then shape how we can approach our health behaviors, which lead to disparities downstream in disease, injury, and mortality.
Graphic Social Determinants of Health

Resources, Bibliography & Links

Social Determinants of Health 



Biblical Mandate to Smile

Smiles are not just good for others; they are good for you too. Smiles reduce stress and enhance the immune response. They make you look younger and more attractive. Smiling releases endorphins and serotonin, elevates the mood and keeps you happier.

Smiles are contagious, they light up the world. Like a candle, a smile can light many lights without itself being diminished. If you smile at 5 people, and they pass the smile on to 5 people and they pass it on to 5 more… then by the 15th passing on, you have smiled at the whole world J

Greeting every person with a smile is healthy advice. The law of greeting with a smile is rooted in the the bible. “His eyes shall be red with wine, and his teeth white with milk” (Gen. 49:12).  Thus, smiling at another is greater than giving him a glass of milk.   Or as I heard in a lecture, the white teeth of a smile is better than how white the milk is.  It’s better to be around people who smile, than someone who has material possessions, but are not pleasant company.

What if you don’t like someone?

Look deep inside each one. Uncover that which is unique and special. Use your  thoughts and intellect, to find what’s good inside. Look for thetheir inner goodness. Everyone has some. Shammai is telling us to find it, connect to it, and respond to it, with an affirming, accepting, tooth sparkling smile. Your white teeth are more delicious than milk!

Consider smiling more often. And as you do, see if you can look past the outside, past the parts of a person that are hard for you like. Take an extra moment and seek out, their inner goodness, and build a bridge from your heart to theirs.  A Bite of


#Medicare10050 and You  2024
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