Pic 0: A title screen appears with the words “Social Determinants of Health”. Then Danielle appears on an abstract background.
DANIELLE: We are bombarded by statistics and research in our work but how often do we reflect on what they mean for the patients we see every day?
Pic 1: A dark blue screen appears, titled “Pregnancy related Mortality Rate: CDC’s national Pregnancy Mortality Surveillance System 2011 to 2015”. A picture of a pregnant woman appears split in two colors. On the left, the words “WHITE women” appears to represent the lefthand color, while on the right the words “3.3x higher BLACK women” is shown on the right to represent the righthand color.
Pic 2: Another screen is displayed, titled “COVID 19 Mortality Rate: Provisional data collected by the New Jersey Department of Health 2020 to 2021”. An illustration of a man is presented who is also split in two colors. The left side and color is labeled “WHITE men”, while the right side and color is labeled “7x higher HISPANIC men”.
Pic 3: Another screen is displayed, titled “Suicide Attempt in High Schools: Nationwide data collected by the CDC 2015”. An illustration of a teenager is split into two colors. The left side and color is labeled “HETEROSEXUAL students”, and the right side and color is labeled “4.5x higher LESBIAN, GAY, & BISEXUAL students”.
Pic 4: The screen returns to Danielle on an abstract background.
DANIELLE: All of the statistics I shared were true, yet they can feel unbelievable. How do these health disparities remain?
There are factors that affect peoples’ health that aren’t within our control as healthcare providers.
We call these factors social determinants of health.
Pic 5: A semi transparent band cuts across the screen with the following text:
Social Determinants of Health
Defined by the CDC as conditions in the places where people live, learn, work, and play that affect a wide range of health and quality of life risks and outcomes
Pic 6: The screen then splits into two halves, the left half in red with the word “Diabetes” with an icon of a blood droplet in a blood glucose monitor, and the right half in blue with the words “Healthy Diet” with icons of vegetables.
DANIELLE: For example, a healthy diet is key to preventing and managing a form of diabetes. But it’s harder to eat healthy if you don’t have a grocery store nearby, so where you live and what you can buy affect your likelihood of developing diabetes and your ability to manage that condition.
Pic 7: Screen returns to Danielle. The following list emerges to the left:
Social Determinants of Health
Healthy food (represented by an icon of vegetables)
Education (represented by an icon of a book)
Employment (represented by an icon of a handshake)
Discrimination (represented by an icon of a person with the cancel symbol)
Relationships (represented by an icon of a heart)
Physical safety (represented by an icon of a shield and a check mark within)
DANIELLE: The ability to access healthy food is just one of many conditions that can impact health. Education and employment opportunities, personal and community wide discrimination, your relationships and the physical safety you experience are among other complex factors that contribute to your overall health.
The amount of control we have to change these conditions in our own lives is variable, and often they’re related to how and where we were born, public policies, and other things we didn’t get to choose.
But we have more power than we think to address these inequities.
Pic 8: A screen titled “Opportunities to Reduce Barriers to Better Health” appears with the following list. Each item has a checkmark next to it:
Get involved in local and national government
Suggest ways your organization can improve access or be more inclusive
Participate in outreach to underserved populations in the community
Partner with nonprofit organizations
Check the Resources page for more ways to help reduce health disparities.
DANIELLE: Although it takes time and coordination, systems approaches that improve the structures of how we live and work gets results.
Pic 9: Screen returns to Danielle on an abstract background.
Then there are things I can do today, when I’m sitting across from a person, having a conversation. Right now, I can do my best to understand their perspective and be empathetic.
There’s a lot going on in the lives of those I care for; relevant details that I might not be aware of. Maybe it was difficult for them to travel to their appointment. Maybe they are a single parent with two jobs and no time to themselves. Or maybe they have insurance coverage issues, or have had bad experiences seeking care in the past.
Pic 10: The words “Motivational Interviewing” appears on the left of Danielle. The words “Open ended questions” is displayed first with an accompanying icon of a question mark and lines extending outwards. This is followed by the word “Affirmation” with three speech bubble icons with check marks within. Finally, the word “Reflections” follows, represented by two arrows circling each other.
I can learn more about these details using motivational interviewing techniques. Asking open ended questions invites someone to share more relevant information. Using affirmations and reflections, I can show empathy; that I’m listening, I care, and I respect their choices.
Pic 11: The three earlier icons decrease their size and are lined up next to Danielle.
In addition to motivational interviewing, there are some other techniques I use to provide sensitive care.
Before I start, what is your experience working with transgender, non binary, or gender diverse individuals?
Pic 12: A questionnaire screen is displayed with selections grouped into three categories. A checkmark is displayed when a category is selected:
How experienced are you with gender diversity?
Choose one.
Section one:
I identify as gender diverse.
I have gender diverse friends or family.
I have treated gender diverse patients.
Danielle’s feedback if section one was selected: I’m glad you’re familiar with gender diversity. I’d like to share with you some of my experiences working with gender diverse patients. Maybe you will learn something new, or hear a different perspective.
Section two:
I have learned about care for gender diverse patients.
I have little or no experience with gender diverse individuals.
Danielle’s feedback if section two was selected: That’s ok! I’d like to share with you some of my experiences working with gender diverse patients.
Section three:
What does “gender diverse” mean?
Danielle’s feedback if section three was selected: “Gender diverse” may refer to someone who identifies differently from the sex they were assigned at birth. That might include a transgender man or woman, or someone who is nonbinary, who identifies as neither gender or both. I’d like to share with you some of my experiences working with gender diverse patients.
The definition for “Gender diverse” appears as “Someone who identifies differently form the sex assigned at birth.”