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Objectives: Upon completion of the chapter and exercises, the learner will be able to
Explain health disparities and characteristics of populations that are at an increased risk for health care disparities.
Define individual patient populations requiring unique considerations in the provision of their health care.
Identify opportunities for student pharmacists and pharmacists to promote patient-centered care to improve health outcomes for individuals from specific populations.
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Health disparities or inequities are defined as gaps in health across different groups of people.1 These gaps are affected by a patient's unique circumstances, including race, ethnicity, social network, status, ability status, gender identity, sexual orientation, geographic location, and socioeconomic status (SES).1 Populations affected by health disparities may be described as vulnerable, underserved, or special. Regardless of the terminology used, patients described in this context warrant additional considerations in their care. Steps to address health disparities go beyond addressing a person's lifestyle; each of the items mentioned must be considered to impact a person's health.1
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Social determinants of health (SDOH) are the environmental conditions where a person is born, lives, plays, and works that impact health outcomes and quality of life (Fig. 19.1).2
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Understanding the complexities surrounding SDOH and their impact on the provision of care and health outcomes is critical for providing high-quality care and addressing health disparities. A patient's SES, which describes a person's income or wealth, education, and occupation, is one of the strongest predictors of health outcomes.3 Increasing SES provides people with more material, psychological, and social resources, which can have positive effects on their health. Unemployment has been linked to poorer health, as it often directly impacts a person's ability to access insurance, subsequently impacting their ability to obtain care and medications.1 Inconsistencies with employment may lead to food insecurity, which describes consistent access to enough food.1 This dietary limitation can lead to obesity and the subsequent cascade of comorbidities often seen with it, such as diabetes and hypertension. Consistent employment also determines the ability of a person to obtain stable housing. Instability in employment status, food availability, or housing can predispose patients to negative consequences such as depression, substance abuse, and stress-related illnesses such as stroke.1 Reliable transportation is another barrier for patients with low SES, often resulting in an inability to seek care when needed and missed appointments. Understanding these SES factors and how they impact patients is needed in order to establish appropriate health goals and improve their well-being.1
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Another SDOH that directly impacts health outcomes includes a patient's ...