Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association.
Heart failure is a clinical syndrome that affects >6.5 million Americans, with an estimated 550 000 new cases diagnosed each year. The complexity of heart failure management is compounded by the number of patients who experience adverse downstream effects of the social determinants of health (SDOH). These patients are less able to access care and more likely to experience poor heart failure outcomes over time. Many patients face additional challenges associated with the cost of complex, chronic illness management and must make difficult decisions about their own health, particularly when the costs of medications and healthcare appointments are at odds with basic food and housing needs. This scientific statement summarizes the SDOH and the current state of knowledge important to understanding their impact on patients with heart failure. Specifically, this document includes a definition of SDOH, provider competencies, and SDOH assessment tools and addresses the following questions: (1) What models or frameworks guide healthcare providers to address SDOH? (2) What are the SDOH affecting the delivery of care and the interventions addressing them that affect the care and outcomes of patients with heart failure? (3) What are the opportunities for healthcare providers to address the SDOH affecting the care of patients with heart failure? We also include a case study (Data Supplement) that highlights an interprofessional team effort to address and mitigate the effects of SDOH in an underserved patient with heart failure.
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D003695:Delivery of Health Care D004522:Educational Status D004781:Environmental Exposure D005006:Ethnicity D000084884:Food Insecurity D005783:Gender Identity D057220:Health Literacy D006297:Health Services Accessibility D054624:Health Status Disparities D006333:Heart Failure D006801:Humans D019458:Insurance Coverage D008913:Minority Groups D008962:Models, Theoretical D004364:Pharmaceutical Preparations D011203:Poverty D044469:Racial Groups D012923:Social Class D064890:Social Determinants of Health D012944:Social Support D014478:Unemployment D035862:Vulnerable Populations
social determinants of health heart failure AHA Scientific Statements health personnel