HPC Corner: DON’T SWIPE LEFT! THIS IS NOT ANOTHER ARTICLE ON SDH

Hardik Valand BS, MS-IV, American University of Integrative Sciences.
Raymond K Tu MD MS FACR, Progressive Radiology, United Medical Center, The George Washington University, Washington, DC.
“Social Determinants of Health (SDH)” are little known to neuroradiologists. SDH are recognized as key influences to healthcare. The American Society of Neuroradiology (ASNR) annual meeting will be the first national radiology meeting where SDH will be defined, discussed and appear in any major body of radiology literature. SDH is a key factor in the discrepancy between healthcare spending and outcome. The World Health Organization (WHO) defines SDH as conditions in which people are born, grow, live, work and age.1 Health plans, independent of how funded, must measure and adjust for SDH-factors as paid maternity leave, childhood development, access and cost to education, income and its distribution, social exclusion, ethnic heterogeneity, immigration, firearm and drug-related deaths. Inevitably social determinants of healthcare create risk and influence all areas of medicine.

 

WHO defines human rights to health as “the individuals’ rights to the highest attainable standard of physical and mental health, which includes access to all medical services, sanitation, adequate food, decent housing, healthy working conditions, and a clean environment.”2 The United States (US) is the only major developed country that does not provide all citizens universal healthcare coverage.3 With the ASNR Annual Meeting in Vancouver, BC, it is fitting that a critical comparison between the Canadian and US systems will be discussed at several sessions. The US-Canadian border, the longest international border in the world between 2 countries, extends 5,425 miles of which 1,538 is shared with Alaska. (The US- Mexican border is 1,922 miles).4 Despite our shared border, heritage, culture, language, and name of our respective currency, health delivery systems are different. Canada has a two-tier publicly-funded universal healthcare, whereas the US has multiple complex systems as a State and Federal subsidized system (Medicaid), prepaid system (Medicare), and employer-sponsored private insurance. Differing access and utilization profiles of MR (Magnetic Resonance) and CT (Computed Tomography) services between Canada and the US are striking. The insured in the U.S. system enjoy timely care and easy access to services such as MRI and CT; not so for the 28.2 million uninsured US citizens.5 Canadians on the other hand have universal access to less expensive care, but prolonged wait times for procedures and imaging. Which is superior? If longevity is your ruler, Canadians live longer. Differences between the US and Canada may be explained by Social Determinants of Health and the demand on health resources between our 2 countries. Stay tuned for more at the ASNR Annual Meeting in Vancouver, BC, Canada.

References

  1. About social determinants of health. World Health Organization Web site. http://www.who.int/social_determinants/sdh_definition/en/. Updated 2018.
  2. Human rights and health. World Health Organization Web site. http://www.who.int/mediacentre/factsheets/fs323/en/. Updated December 2017.
  3. Lendman S. America the only developed country without universal healthcare. Global Research Web site. https://www.globalresearch.ca/america-the-only-developed-country-without-universal-healthcare/5598311. Updated July 9, 2017.
  4. What countries does Canada have borders with? Canada FAQ Web site. http://www.canadafaq.ca/what+countries+canada+borders+with/. Updated 2015.
  5. Key Facts about the Uninsured Population. Kaiser Family Foundation Web site. https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/. Updated November 29, 2017. Accessed October 20, 2017.

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