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Social determinants of health include neighborhood opportunity

A research study recently published by JAMA Network Open found that health inequities are pervasive among socially vulnerable populations across the country. Those inequities affect life expectancy as well as overall health conditions and outcomes. In fact, life expectancy can span a range from 56 to 97, depending on the individual’s geographic location.

Community-level conditions are described in terms of neighborhood opportunity and geography of opportunity. These areas of concerns have implications for long-term health as well as child development and socioeconomic outcomes. Community-level conditions can include factors related to education, the environment, socioeconomic factors, and health, and can account for at least part of the association between health and neighborhood poverty.

Targeting these specific factors is best done at the neighborhood level. Investing in communities and improving opportunities for education, employment, and a positive physical environment can alter patients’ health outcomes across their lifespan, including extending their life expectancy. The research study found, however, that there are gaps in the knowledge base about the impact of neighborhood opportunities on health levels and life expectancy.

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The social determinants of health all work together to affect population health within the community. For example, improved access to better education can lead to stronger employment potential, resulting in a higher income level. This, in turn, helps families afford better quality housing and food - as well as access to better healthcare resources.

Neighborhood indicators that have been associated with the greatest increases in life expectancy include:

  • A lower housing vacancy rate

  • Higher median household income

  • Fewer single-headed households

  • A lower public assistance rate.

Public assistance is defined as those in the community who are receiving cash or support from programs such as the Supplemental Nutrition Assistance Program (SNAP).

Life expectancy has been in decline for the past two years, in part due to the effects of the COVID-19 pandemic. The most recent figures released by the Centers for Disease Control and Prevention (CDC) reveal that the rate in 2021 was at its lowest level since 1996, falling from 77 to 76.1. Experts state that an individual’s zip code can be a predictor of their health status and life expectancy.

A DPC practice that provides families with basic, preventive healthcare services for a reasonable monthly fee could be part of the solution to the challenges faced by patients who might not otherwise be able to afford quality care. The research study found that children, in particular, are impacted by community resources and conditions. Improved healthcare early in life can impact the individual’s long-term outcomes as well as life expectancy.

While these risk factors are not easily changed at the population or individual level, improvements in areas such as environmental cleanliness and improved healthcare access can make a difference for socially vulnerable populations.