Social Determinants of Health and the Impact on Older Adults Living in Poverty
Social determinants of health (SDOH) play a critical role in molding an individual’s overall well-being, particularly as they age. “SDOH are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks” (Whitman et al., 2022). These determinants cover a wide range of elements, from housing and economic stability to education, social and communal context, health care, and the built environment of the neighborhood. For older adults, the interaction between these social determinants becomes even more critical, particularly for those living in poverty. This essay will discuss how social determinants of health for the older adult are impacted for those living in poverty.
Economic Stability
Economic stability is a fundamental element that influences many areas of an older adult’s life. For those living in poverty, housing becomes a primary concern, often consuming a significant portion of their limited financial resources. In Texas, for example, a sizable proportion of elderly persons spend more than 30% of their income on housing (Fournier, n.d.). This financial burden limits their capacity to buy healthy meals, medical demands, and other necessities. The relationship between poverty and health is clear, with research finding that low-income persons are approximately five times more likely to have poor health. Poverty among elderly Texans, estimated at 4.5 million people, exacerbates the obstacles they experience in maintaining good health.
Education
Health literacy, defined as the understanding of necessary medical information for informed decision-making, is inextricably linked to education. Poverty often creates barriers to accessing and comprehending health-related information for older adults (Perez et al., 2022). In Texas regions where nearly 70% of people have basic or below-basic health literacy, efforts to educate older adults are critical (Fournier, n.d.). Addressing these literacy gaps has the potential to empower older Texans to make informed health decisions, potentially reducing emergency service utilization and associated costs.
Social and Community Context
Social isolation and loneliness are serious threats to the health of older adults, especially those living in poverty. Limited financial resources may limit opportunities for social engagement and participation in community activities. As a result, social isolation can increase the risk of falls, cognitive decline, and cardiovascular problems. Addressing these challenges requires a multifaceted approach that takes into account the unique social and community contexts of poor older adults.
Health and Health Care
The burden of chronic conditions is a common challenge for older adults, with approximately 40% of Medicare beneficiaries aged 65 and older having four or more chronic conditions. Health care costs are 51 percent higher in older age for those who were previously uninsured than for their insured counterparts (Fournier, n.d.). The consequences of insurance status throughout one’s life highlight the importance of equitable access to healthcare. Furthermore, the important role played by unpaid family caregivers in assisting older adults with daily tasks must be recognized. In Texas alone, family caregivers provide over 3.2 billion hours of care, representing a significant but often overlooked aspect of healthy aging.
Neighborhood and Built Environment
Geographical location and the built environment have a significant influence on the health of an older adult. Disparities in healthcare resource distribution, such as the predominance of doctors in metropolitan areas, add to the issues experienced by older persons in rural areas (Gómez et al., 2021). Social isolation is exacerbated in rural locations due to restricted availability to public transportation and a variety of health and social services. Furthermore, the problem of food insecurity, which affects 10.5 percent of Texans aged 60 and older, underlines the need of providing healthy and cheap food alternatives near to the homes of older persons.
In conclusion, healthy aging is a complicated and varied public health problem, especially for poor older persons. The interaction of social determinants of health has a substantial impact on this vulnerable population’s overall well-being. Economic instability, low educational resources, social isolation, healthcare issues, and environmental variables all contribute to the particular health concerns of poor older persons. Addressing these difficulties requires a multifaceted, multidisciplinary approach that acknowledges the linked nature of socioeconomic variables.
References
Fournier, S. (n.d.). Social Determinants of Health in Aging. Texas Health and Human Services. https://www.hhs.texas.gov/sites/default/files/documents/about-hhs/community-engagement/atw/atw-social-determinants-health-aging.pdf
Gómez, C. A., Kleinman, D. V., Pronk, N., Gordon, G. L. W., Ochiai, E., Blakey, C., … & Brewer, K. H. (2021). Practice full report: addressing health equity and social determinants of health through healthy people 2030. Journal of Public Health Management and Practice, 27(6), S249. doi: 10.1097/PHH.0000000000001297
Perez, F. P., Perez, C. A., & Chumbiauca, M. N. (2022). Insights into the social determinants of health in older adults. Journal of biomedical science and engineering, 15(11), 261. Doi: 10.4236/jbise.2022.1511023
Whitman, A., De Lew, N., Chappel, A., Aysola, V., Zuckerman, R., & Sommers, B. D. (2022). Addressing social determinants of health: Examples of successful evidence-based strategies and current federal efforts. Off Heal Policy, 1-30. https://www.aspe.hhs.gov/sites/default/files/documents/e2b650cd64cf84aae8ff0fae7474af82/SDOH-Evidence-Review.pdf
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