Community Pharmacists Can Address SDOH, Advance Health Equity
Researchers conducted a survey asking pharmacists their perspectives on addressing patients’ social determinants of health.
Community pharmacists are best positioned to address patients’ social determinants of health (SDOH) and advance health equity, according to a survey published in Preventative Medicine Reports.1 However, with depleting resources and staff, researchers agreed pharmacies need more funding and training to improve population health.
“SDOH can significantly impact health risks and outcomes,” wrote authors of the study. “Exposure to social factors such as unsafe housing, poverty, and lack of health insurance can impact patients' adherence to treatments and contribute to unequal access to health care resources, worse health outcomes, and significant economic impacts.”
Experts believe community pharmacies are a premier health care destination where patients can address their social barriers. | image credit: JD8 / stock.adobe.com
SDOH can be any force or system impacting conditions of a patients’ daily life, including how they are born, grow up, work, live, and age. Authors of the study noted that SDOH can account for up to 90% of the population’s health outcomes. However, according to the World Health Organization, SDOH are estimated to be responsible for 30% to 55% of all health outcomes.2
READ MORE: Community Pharmacists as Experts on Complex Patient Encounters
Regardless of how many patients SDOH commonly impact, providers agree that there is a need to address these social factors. They also agree, however, that staffing shortages, burnout, and a lack of resources are significantly hindering health care’s ability to improve population health.
According to a University of Illinois, Chicago, survey, over 87% of pharmacists were at high risk of burnout after the COVID-19 pandemic.3 Furthermore, a National Community Pharmacists Association (NCPA) survey reported that over 75% of community pharmacists were having a difficult time filling open positions.4
“Community pharmacies are the most accessible health care setting in the US and are promising venues to complement current SDOH screening and intervention efforts,” continued authors of the study.1 “Most US residents (89%) live within 5 miles of a community pharmacy and availability of pharmacy locations is 15% higher than physician practices in low-income areas.”
With an apparent need to garner more focus on the social factors influencing patients, experts believe community pharmacies are a premier health care setting. For general patients not commonly experiencing chronic conditions, pharmacists are most often the provider that patients are most familiar with. As patients are in search of providers with equal medical and social skills, experts hypothesized that community pharmacists are the best resource for helping patients overcome SDOH.
“Our objective was to evaluate pharmacists' perspectives on SDOH by identifying social barriers affecting patients, assessing pharmacy staffs' ability to address barriers, and determining what resources are available or needed to address patient social barriers in pharmacies,” the authors wrote.1
Researchers conducted a community pharmacists survey from September 2022 to January 2023. The survey included a total of 81 items designed to evaluate respondents’ perceptions of SDOH. Pharmacists were asked about a variety of social barriers patients may face, including food insecurity, transportation, low income, high medication costs, low education level, exposure to crime or violence, and more.
A total of 578 pharmacists (mean age, 47 years; 51% men; 13% Asian) were recruited to take the survey. For 209 survey respondents, they reported that more than 25% of their patients experienced social barriers, while only 3% reported that their patients experienced no SDOH.
Within the domain of health care access and quality, low income (68%) and transportation (48%) were the biggest barriers in patient experiences. When asked which social barriers were addressable, 59% of respondents mentioned health care access and quality as the most addressable, while just 24% said education and neighborhood/built environments were least addressable.
Results of this survey showed that community pharmacists agree on the existence of SDOH and how they are significantly impacting patients. While providers around the country agree that these barriers need to be addressed, they believe more funding and training is necessary to advance these improvements.
“This study underscores the potential for community pharmacies in the US to play a pivotal role in addressing SDOH and advancing health equity. Pharmacies are accessible health care settings uniquely positioned to mitigate health disparities, but significant gaps in resources and capacity hinder their ability to fully address patient social needs. Enhancing pharmacy involvement in SDOH interventions through targeted investments, service reimbursement schema, training, and program development could unlock their tremendous potential to be partners in holistic, community-based approaches to improving population health,” concluded the authors.1
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