The annual meeting of the American College of Physicians (ACP) was held from April 19 to 21 in New Orleans and attracted more than 6,000 participants from around the world, including internists, adult medicine specialists, sub-specialists, medical students, and allied health professionals. The conference highlighted recent advances in the prevention, detection, and treatment of illnesses in adults, with presentations focusing on updates in neurology, oncology, infectious diseases, endocrinology, and cardiology.
During the conference, the ACP held a panel discussion to address a new position paper outlining impacts of social determinants of health on patient outcomes. The position paper was published recently in the Annals of Internal Medicine.
“Physicians need to appreciate the importance of socioeconomic determinants of health. Zip codes, perhaps even more than genetic codes, determine life expectancy and health overall,” said panel member John Ende, M.D., immediate past president of the ACP. “The more we know about socioeconomic determinants of health, the more effective we can be as internists in achieving better outcomes for our patients, particularly those who are challenged by poverty, low education, unemployment, and other factors that account for worse health outcomes in our most vulnerable populations.”
In addition, according to Ende, training in socioeconomic determinants of health should be part of the medical school and resident curricula, and should also be emphasized in continuing medical education.
“Moreover, these issues really need to be addressed by policy makers at the local, state, and federal levels. The ACP calls for more funding for research in this area. Research is needed to identify the best strategies for internists to use to identify when a patient’s health is impacted by socioeconomic factors,” Ende added. “Equally important, research is needed to identify the most effective approaches to address these problems at the individual, patient-physician, and population levels.”
Furthermore, Ende noted, an appreciation of the socioeconomic determinants of health enables physicians to understand, for example, why patients with asthma find themselves repeatedly in the emergency room with recurrent attacks of asthma, why patients with hypertension don’t achieve appropriate blood pressure control, and why patients with diabetes are unable to reach recommended glycemic targets.
“Treatment failures such as these are often directly related not to biologic factors, but to socioeconomic factors,” Ende said. “Physicians need to become aware of the importance of socioeconomic determinants of health and discuss them with their patients. This will enhance the bond between patients and physicians. This bond is so important for achieving positive health outcomes, particularly for our most vulnerable patients.”