Social Comorbidities: It’s Not All About The Pills

Modern healthcare is mostly centered around quick, easy solutions, and it seems to ignore many aspects that have a huge impact on how people develop illnesses, cope with them, and even receive treatment in the form of the aforementioned quick fixes. Doctors observe a patient, discover a health issue, and reach out for a prescription label blank without considering the patient’s economic and social circumstances. Meanwhile, these very same circumstances could be crucial factors determining the possible health outcomes for this patient.

What Does A Fridge Even Have To Do With Diabetes?

Some issues and situations that can affect a person’s health probably won’t even come to your mind unless you witness someone struggling with them. For instance, you may never give much thought to the importance of basic amenities, such as water, sewage, and electricity. They are basic, so pretty much everyone in the US has access to them, right? Well, you’d be surprised at how many Native American reservations still don’t have electricity in every home.

Social Comorbidities

While not being able to use most electronic devices and household appliances that we seem to take for granted at this point is definitely inconvenient, sometimes the negative impact of such a shortcoming goes beyond simple inconvenience. Consider a patient who has diabetes and needs insulin on a daily basis. The solution is simple: provide the patient with a supply of insulin, make sure they understand how to inject it safely, and tell them to store it in the fridge. But what if this patient happens to not have electricity, let alone a refrigerator at home?

Scientific studies and research projects on the topic of diabetes are probably never going to consider the importance of a functioning fridge for a diabetes patient. Yet, the absence of one can make a world of difference for someone suffering from diabetes, as they won’t be able to properly store the medication. Some people will improvise and come up with a half-decent substitution - a cooler and some ice may not be ideal, but they still do a much better job at preserving insulin than any place with room temperature. Others may have to refill their insulin subscription on an almost daily basis or decide that storing it at room temperature is not so bad. Either way, the potential health outcomes for such patients are everything but optimal.

What Exactly Is A Social Comorbidity Anyway?

A comorbidity is an additional medical condition that is also present in someone who is suffering from a “primary” condition. For instance, obesity is often referred to as a comorbidity for a number of health issues, including but not limited to heart attacks, hypertension, and a number of cancer types. A comorbidity doesn’t have to directly contribute to the primary condition or make it worse, but it often has a negative impact on the patient’s overall health and well-being. In addition, it may complicate the treatment of the primary condition by restricting the range of medications that could be prescribed as well as making certain surgical procedures impossible or too dangerous.

What about social comorbidities? Do they accompany certain health conditions just like obesity is frequently present in people with hypertension and ADD in those suffering from anxiety disorders? In a nutshell, yes. However, social comorbidities are not diseases or other medical conditions. The term “social comorbidity” can be used to refer to a wide range of social and economic factors that can influence one’s health and possible outcomes in case of illness.

Housing instability, limited personal mobility, and food insecurity are all great examples of what a social comorbidity can be. Studies will often take these factors into account as a general source of potential complications and negative health outcomes, but they hardly ever go into detail about them. This means that while medical practitioners may realize that diabetes patients without a functioning fridge at home are at a major disadvantage, they probably won’t take any steps towards identifying these patients and working with them to come up with an acceptable alternative.

What Can Be Done About Social Comorbidities?

Social comorbidities are too diverse and complicated for a one-fits-all solution. However, it is important to recognize their presence in people’s lives and the extent to which they may influence a person’s health and well-being. The first steps towards this more profound and wide-spread understanding of social comorbidities are taken by the CMS (Centers for Medicaid and Medicare Services) and hopefully will be replicated by various lower-level organizations.

For instance, the new Accountable Health Communities model developed by the CMS mow recognizes social comorbidities as an important factor in creating the dissonance between community services and clinical care in the modern healthcare system. This means that the CMS is now regarding public health as a product of numerous intertwining factors rather than just looking at from a purely medical perspective.

The CMS also helps bridge the gap between potential CMS beneficiaries and the programs they could benefit from. While there are numerous programs available to provide medical, financial, and psychological support for disadvantaged Americans, many people eligible for these programs simply aren’t able to navigate the sea of acronyms and huge amounts of information they often stand for. This is particularly true for those Medicaid beneficiaries who qualify for assistance programs because of a mental disease or disability.

Of course, the CMS is not the only organization working towards wider recognition of social comorbidities and successful minimization of their impact on public health. Thanks to local efforts, medical and social services are slowly blending together, allowing for a much more effective support system for hundreds of patients. The future endeavors of both the CMS and their local partners will be directed towards more efficient screening procedures for potential CMS assistance recipients as well as a rapid increase in public awareness of social comorbidities and available community services that could help minimize their negative impact.