Growing up in an affluent neighborhood in the suburbs of Chicago and having a parent who worked for the State of Illinois, I took advantage of the access to healthcare and flexible insurance policy I had. I never gave these things much thought, but one day in my junior year of high school, my history teacher said, "Look around at your classmates. Why do you think no one in this room is obese?" The answer was: we lived in an affluent town with grocery stores and pharmacies available every 5 miles and attended a well-funded high school that had gyms and athletic programs. I am privileged enough to say that that was my first experience with social determinants of health (SDOH), and it is very unfair—not for me, but for everyone who does not even get the chance to be in my position.

In my opinion, social determinants of health impact the quality of life and the susceptibility of an  individual to a health issue more than genetics, and this is something that needs to be explicitly taught in elementary and higher level curriculum. A couple flaws of the American healthcare system is that it is a system where anything, even time, can be bought and sold, and the majority of providers tend to focus on the disease state rather than the individual or the relationships we build with the individual. Due to SDOH, many patients opt-out of receiving care for their current health issues because they cannot afford care, or the solution of trying new drugs and medical devices is not remedying their condition. One way we can appeal to the social needs of patients are by involving social workers in the healthcare team and decision-making process. Social workers are trained to deal with crisis situations, provide resources for a plethora of needs, and are even able to arrange transportation for patients that need it. However, the real solution lies in combating systemic racism and discrimination that is present in our society, in order to level out the playing field for underserved populations.

Another flaw of the American healthcare system is its fragmentation. For example, a patient must visit their primary care provider and be referred to a specialist when seeking treatment for a certain problem. This can take weeks to arrange, and a patient may be hesitant to do so since it requires them to take more time off work, spend more money, and find a means of transportation. Reducing fragmentation could take decades, as it requires the reformation of the American healthcare system. It could involve deducing the system to a single payer and limiting reimbursement to providers.

Overall, there is much work to be done when it comes to reforming the healthcare system. The first crucial step is to understand the problem of fragmentation and inequality in order to think of appropriate solutions. To see the healthcare system as a whole instead of individualized parts and to value relationships with patients are key components to increasing the quality of care.

 By Anna Eursiriwan