Addressing the Social and Political Determinants of Health Requires Broad, Unified Action – and Immediate Focus
By Squire Servance, Founder and Managing Partner of Syridex Bio and Michellene Davis, Esq., President and CEO of National Medical Fellowships
Following the COVID-19 pandemic, the deep disparities in American healthcare have never been clearer. Though the virus’ threats have receded, symptoms of the underlying problem continue to multiply: The U.S. life expectancy is at its lowest in nearly two decades.
Communities of color, in particular, remain hardest hit by health disparities: Black people are almost four times as likely as white people to develop kidney failure; Latina/Hispanic women have triple the likelihood of dying of HIV infection. These are merely examples of a widespread crisis.
Untangling the complex matrix of systemic issues in our health system can seem like a monumental task. However, understanding the social and political determinants of health (SPDOH) – and our potential agency within them – offers a practical and wise place to start.
UNDERSTANDING THE SOCIAL AND POLITICAL DETERMINANTS OF HEALTH
Social determinants of health are defined by the CDC as “nonmedical factors that influence health outcomes”—that is, the conditions in which people are born, along with the larger systemic forces that shape their daily lives. Social determinants can have an outsized impact on health outcomes, more so than even health care or lifestyle choices.
The Department of Health and Human Services organizes the social determinants of health into five categories: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. We complement these social determinants with political determinants of health — which, as health policy expert Daniel Dawes explains, involve the “systematic process of structuring relationships, distributing resources, and administering power in ways that either advance health equity or exacerbate health inequities.”
Together, these social and political determinants of health (SPDOH) reveal both person-by-person and systemic disparities in health outcomes, adding up to basic and deeply rooted health care inequity.
Addressing – and dismantling – these inequities requires urgent, cross-sector, collaborative action akin to the global pandemic response. Indeed, lives are at stake, and success takes a village.
At Syridex Bio and National Medical Fellowships, Inc. (NMF), we believe our synergistic work offers one example of how unified action can deliver deeper impact than the sum of its parts.
SYRIDEX BIO LEVERAGES PRIVATE CAPITAL TO IMPROVE HEALTH CARE ACCESS AND QUALITY
At Syridex Bio, we have zeroed in on health care access and quality as the SPDOH in which we can make the greatest impact. To drive progress, we target investments in therapies that treat diseases disproportionately affecting minoritized communities.
The biotech industry has long neglected potential treatments for diseases most prevalent in smaller and underserved communities. Indeed, for-profit biotech and pharmaceutical companies are often financially incentivized to invest in drug therapies with potential use for the broadest markets.
But those same market forces can be rechanneled through a health equity lens to reveal tremendous untapped market potential. Better still, that investment upside also brings opportunities to better serve patients.
We believe our work can meaningfully accelerate health equity, prioritizing treatments for communities whose maladies have long been overlooked. Nonetheless we also understand that our work is only addressing the problem from one direction.
NMF LEVERAGES NON-PROFIT RESOURCES TO EXPAND ACCESS
Recognizing that systemic racism limits access to quality health care — and particularly, culturally competent care — for communities of color, NMF works to expand access to education in healthcare and support students chronically underrepresented in medicine.
NMF offers scholarships to Black, Latine, Indigenous and People of Color students aspiring to be healthcare leaders. We believe increasing the number of health professionals from the very communities enduring the highest levels of health inequity is key to addressing mistrust in health care and achieving lasting health equity.
NMF programs provide crucial financial support to diverse medical students, who are statistically more likely to practice in underserved communities and advocate for health equity. For instance, the NMF Diversity in Clinical Trials Research program (NMF Dctr) aims to increase the number of clinicians of color serving as Principal Investigators, as part of the strategy to improve patient diversity in research. Such change will ensure therapeutics and disease prevention efforts have greater efficacy across all populations.
MULTI-PRONGED APPROACH: GOVERNMENTAL ACTION IS CRITICAL
Of course, private action alone – whether philanthropic or in the capital markets – is not enough. This crisis calls for public, governmental action, as well. The Health Equity and Accountability Act, introduced by Senators Cory Booker and Raphael Warnock to provide a roadmap for eliminating racial and ethnic health inequities, is one example of recent public action complementing our efforts.
Public and private initiatives, operating in tandem, create a positive feedback loop, amplifying progress toward improving health care access and quality. This crisis requires multi-faceted action.
JOIN THIS EFFORT
Big problems like this have always required public-private partnerships and united effort across different sectors. The good news is that we have a village of problem-solvers. That’s why Syridex Bio and NMF have partnered to elevate a call-to-action for more partners to join the health equity cause.
The breadth of this crisis is daunting, but also empowering — imparting upon each actor the agency and potential to generate real impact.
So, our call-to-action is simple: Partner with impactful initiatives already underway, such as the NMF Dctr program, that work to ensure that long-excluded populations are included in the health equity effort. Or, find the realm in which you and your firm has a competitive advantage to deliver the most meaningful progress – and drive your impact there.
Truly, success will take a village.