Social Determinants of Health: the Impact of Neighborhood and Physical Environment
Last month, MTM’s Senior Director of Digital Products Nader Hawit explained what food insecurity is, and how access to resources and healthy food options is an important social determinant of health (SDOH). This month, he explains how an individual’s neighborhood and physical environment has a huge impact on not only food access—but also how it alters all six segments of the social determinants wheel.
Let’s Look at the Facts
Where people live have a huge impact on their health and wellbeing. It’s a factor that many don’t think about when it relates to health outcomes. But when you look at the data, it’s easy to see how physical environment can affect an individual’s overall health. Housing quality is so much more than just the neighborhood we live in—it also refers to the physical environment of our homes, from air quality and the presence of contaminants like mold and asbestos to the space allotted per resident.
Did you know:
- 46 million US residents live in poverty.
- A little over half a million Americans are unhoused.
- 52% of unhoused individuals were reported in major cities, while 23% are located in largely suburban areas.
- The supply of primary care providers per capita is lower in rural areas compared to urban areas.
- About 12.3% of people in completely rural counties lack health insurance and access compared to the 11.3% for mostly rural counties, and 10.1% for mostly urban counties.
- One out of four older people fall each year.
Camber Mental Health says that “One big factor that impacts our health is the conditions in which we live. Health starts in homes, schools, workplaces, and communities. Our access to social and economic opportunities, such as the quality of schools, safety of workplaces, and the availability of clean food and water, all impact our health.” Without this, we see how big the impact our environment and physical location has on SDOH.
Factors Outside of Healthcare Access
Although it is important to address healthcare accessibility, especially in rural areas, it is also important to address locations with high crime rates, unhealthy atmospheres, and home environmental safety. Crime rates often induce trauma and can lead to behavioral health disorders. SAMHSA says, “It’s important to address the impact of trauma (due to substance abuse, crime, and more) on individuals, families, and communities as a behavioral health concern that requires a healing and recovery process.” A recent study in the American Journal of Public Health also showed that higher rates of neighborhood safety fears may lead to poorer self-rated physical and mental health.
This can be in part to unhealthy living standards. Unhealthy living standards include lack of resources like clean water, air quality, accessibility for people with disabilities, and more. If these standards are not met, they can adversely impact immunocompromised individuals, cause developmental delays in children exposed to hazards like mold and lead-based paint, and even cause harm to those with respiratory conditions, such as COPD or asthma. Measures like home safety modifications reduce the risk of falling, keep unwanted molds and mess out, and ultimately ensure individuals live independently and safely in the comfort of their home.
The Impact of Transportation
Low-income families, like those who qualify for Medicaid, are more likely to live in lower quality housing that can have long-term negative effects on health, including chronic disease, injury, and adverse mental health. These individuals have the biggest need for non-emergency medical transportation (NEMT) services. There are several ways in which MTM can help address these concerns.
NEMT is a foundational tool that helps break down the access barrier. Creating an easy-to-use and reliable delivery system develops stronger member adoption. Once adopted, we see significant outcomes as a result of appointment adherence. NEMT overall helps bridge the gap for underserved communities to create access to social and medical needs.
MTM also breaks down barriers beyond transportation. It starts with screening to understand social needs and using our network of credentialed vendors to meet the member where they are. With our home and community based services solution, we can also close gaps in food insecurity, isolation, and home safety, and enable alternate therapies. MTM continues to look for partnerships that will help us work towards our vision of communities without barriers, mitigating risks associated with SDOH one step at a time.