Addressing Social and Structural Determinants of Health in the Delivery of Reproductive Health Care
Summary of Recommendations and Conclusions
- Health care professionals should be aware of and understand the social and structural drivers that affect health outcomes. They should acknowledge that race, institutionalized racism, and other forms of discrimination serve as social determinants of health.
- To provide patient-centered care, each routine office visit should include appropriate questions about social and structural drivers of health that may influence a patient’s health and use of the health care system. It is important to be cognizant that screening for social and structural drivers may not elicit open responses from all patients due to perceived stigma or fear of negative consequences (eg, social services involvement) or both.
- An individual health care professional's biases (whether overt or unconscious) affect delivery of care and may exacerbate and reinforce health disparities through inequitable treatment.
- Obstetrician–gynecologist practices that are part of a community health care clinic or larger networks should encourage their facilities to establish medical–legal partnerships.
- Health care professionals should maximize referrals to appropriate services to help improve patients’ abilities to fulfill needs identified by screening for social and structural determinants of health.
- Health care professionals should be aware of and make allowances for transportation and other logistical difficulties and differences.
- Health care professionals should advocate for policy changes that promote safe and healthy living environments.
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Overview
Title
Addressing Social and Structural Determinants of Health in the Delivery of Reproductive Health Care
Authoring Organization
American College of Obstetricians and Gynecologists
Publication Month/Year
October 17, 2024
Last Updated Month/Year
October 18, 2024
Document Type
Consensus
Country of Publication
US
Document Objectives
Social and structural determinants of health include historical, social, political, and economic forces, many of which are rooted in racism and inequality, that shape the relationship between environmental conditions and individual health. Unmet social needs can increase the risk of many conditions treated by obstetrician-gynecologists (ob-gyns), including, but not limited to, preterm birth, unintended pregnancy, infertility, cervical cancer, breast cancer, and maternal mortality. An individual health care professional's biases (whether overt or unconscious) affect delivery of care and may exacerbate and reinforce health disparities through inequitable treatment. Obstetrician-gynecologists and other health care professionals should seek to understand patients' health care decision making not simply as patients' individual-level behavior, but rather as the result of intersecting sociopolitical conditions, structural inequities, and social needs that create and maintain inequalities in health and health care. Recognizing the importance of social and structural determinants of health can help ob-gyns and other health care professionals to better understand patients, effectively communicate about health-related conditions and behavior, and contribute to improved health outcomes, including patients' experience of care and their trust in the health care system.
Inclusion Criteria
Female, Adult
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Counseling, Management
Diseases/Conditions (MeSH)
D060728 - Reproductive Health, D064890 - Social Determinants of Health
Keywords
social determinants of health, SDOH, reproductive care
Source Citation
Addressing Social and Structural Determinants of Health in the Delivery of Reproductive Health Care: ACOG Committee Statement No. 11. Obstet Gynecol. 2024 Nov 1;144(5):e113-e120. doi: 10.1097/AOG.0000000000005721. PMID: 39418666.