These data are important, but we aren’t ready to collect them yet
Making sure this valuable information is collected and integrated into routine care could help solve that disconnect. But there are many hurdles to proposals for putting this information into use.
Right now health care providers don’t get paid for collecting, documenting or using these data. And medical training and clinical care guidelines do not yet teach providers how to incorporate these factors into care, so they would need instruction on what to do with this new social, environmental and community information.
And most clinical risk models do not include environmental, community or social determinants of health. Researchers have noted, for instance, that the Framingham Risk Score, which is used to predict risk of coronary heart disease, leads to underdiagnosis of cardiovascular disease in populations of low socioeconomic status (SES), because it doesn’t take SES into account. But integrating SES and other determinants of health in established risk calculators and clinical protocols will require investments by health care systems.
Policymakers and scientists are already meeting to develop a large-scale effort in response to the Precision Medicine Initiative. We believe that it is critical that community, economic, environmental, behavioral and social determinants of health are part of these discussions.
Brian S Schwartz, Professor of Environmental Health Sciences, Johns Hopkins University and Annemarie Hirsch, Research Scientist, Joint Geisinger-JHSPH Environmental Health Institute.
This article was originally published on The Conversation. Read the original article.