Hitting The Brick Wall–Health Equity And Social Determinants Of Health
Updated: Jun 15, 2024
Dr. Tomi Mitchell, MD is a leader in the health & wellness industry, known for her advocacy for social issues, including health reform. She believes in the whole person's approach to life and health. Rather than resorting to quick fixes, she gets to the root of problems by taking the time to understand her client's emotional, physical, mental, environmental, financial, spiritual and social health.
I remember studying the social determinants of health in university, memorizing the components for exams. The concepts made sense, but back then, my understanding of the ideas was merely conceptual. I didn’t have much lived personal and collective global experience to truly comprehend this crucial idea. However, fast forward a few decades, and my appreciation of the social determinants of health has grown.
So, you might be asking, what exactly are the social determinants of health? The social determinants of health encompass the various conditions and factors in which individuals are born, grow, live, work, and age, all of which significantly influence health outcomes and disparities. These determinants go beyond individual behaviors and biological factors to include broader societal and environmental contexts.
Here are the 12 determinants of health
Income and Social Status: Economic resources and social standing play a pivotal role in determining access to healthcare, housing, education, and other essentials for maintaining good health.
Employment and Working Conditions: Job stability, workplace safety, and the quality of woking conditions impact physical and mental health outcomes.
Education and Literacy: Levels of education and literacy affect individuals' abilities to understand and navigate healthcare systems, adopt healthy behaviors, and make informed decisions about their health.
Childhood Experiences: Early childhood development, including experiences of trauma, abuse, neglect, and access to nurturing environments, profoundly shape lifelong health outcomes.
Physical Environments: Environmental factors such as air and water quality, housing conditions, access to green spaces, and exposure to pollutants significantly impact health.
Social Supports and Coping Skills: Strong social networks, supportive relationships, and coping mechanisms contribute to resilience and buffer against adverse health outcomes.
Healthy Behaviors: Lifestyle choices, including diet, physical activity, substance use, and adherence to preventive healthcare practices, significantly influence health and longevity.
Access to Health Services: The availability, affordability, and quality of healthcare services, including preventive care, treatment, and mental health support, are critical determinants of health outcomes.
Biology and Genetic Endowment: Genetic predispositions and biological factors influence susceptibility to certain diseases and conditions, interacting with social and environmental determinants.
Gender: Gender roles, expectations, and experiences shape health behaviors, access to resources, and vulnerability to specific health risks and conditions.
Culture: Cultural beliefs, practices, and traditions influence health behaviors, healthcare-seeking behaviors, and perceptions of illness and wellness.
Race/Racism: Structural racism, discrimination, and inequalities based on race and ethnicity contribute to disparities in health outcomes and access to healthcare services.
These determinants can have subtle yet glaring impacts on health. From my own personal experience, I was blessed with access to health resources, quality education, a supportive environment, and more. However, there are two factors beyond my control: my biological gender and my race. I am unapologetically a black woman. Through tumultuous times, I've learned to carry myself proudly, embracing the beautiful, dark-melanated body with which God blessed me. No amount of gaslighting or denial of the impact of being a brown-skinned woman can make me doubt my lived experiences or the collective experiences of other black women.
Just recently, influencer Jessica Pettway, at age 36, passed away a year after being diagnosed with stage 3 cervical cancer. Doctors initially misdiagnosed her condition as fibroids (link to her story). She died on March 11, 2024. Fibroids, though common, particularly in black women, can cause bleeding. A simple screening test, like a routine Pap smear, could have detected cervical cancer years earlier. According to the CDC, 58% of non-Hispanic Black women diagnosed with cervical cancer at an earlier stage live for five or more years. Hispanic, Indigenous, and Black women have higher rates of new cervical cancer diagnoses in the US compared to women of other races.
Another notable example of a black woman who faced challenges in healthcare is Serena Williams. Despite her status as one of the greatest athletes of all time, Serena encountered serious complications after giving birth to her daughter in September 2017. She experienced a pulmonary embolism, a condition where one or more arteries in the lungs become blocked by a blood clot. Despite her history of such medical issues, Serena had to insist on receiving the necessary treatment as medical staff initially dismissed her concerns. This incident shed light on the racial disparities in maternal healthcare, particularly the higher rates of maternal mortality and morbidity among black women in the United States.
Until we address the roots of these biases and dismantle the systems that are inherently biased, we will continue to have these problems. Putting our heads in the sand and pretending that this is no longer an issue will only make matters worse.
Until then, my thoughts and prayers are with those who have encountered biases and hit the proverbial wall. I will continue to use my privilege as an educated female physician, speaker, and writer to advocate for change and shed light on these issues.
Dr. Tomi Mitchell, Holistic Wellness Strategist & Burnout Coach
Dr. Tomi Mitchell, MD is a leader in the health & wellness industry, known for her advocacy for social issues, including health reform. She believes in the whole person's approach to life and health. Rather than resorting to quick fixes, she gets to the root of problems by taking the time to understand her client's emotional, physical, mental, environmental, financial, spiritual and social health. She believes these factors affect individuals' behaviors and beliefs about themselves and others. Dr. Tomi Mitchell believes that people feel lost or overwhelmed when there is a loss of balance – which is why she takes such a holistic approach with each client's situation.
Dr. Tomi Mitchell has appeared in many publications , including , but not limited to Thrive Global, Fox, NBC, CBS, Global News, CBS & many other news outlets. She has her own blog & leads two ClubHouse clubs, and has been a guest speaker numerous times.
She is a game-changer, and she gets her clients results and refuses to compromise her integrity by sugar-coating issues. Using over 10 years as a family practitioner, and certified life & health coach, she is able to help her clients create transformational, long-lasting results!
