Addressing social determinants of community health: Johns Hopkins evacuates due to possible TB exposure

Healthcare is generally assumed as the factor that most affects health of the people. But, it is now becoming evident that more than the medical or clinical factors, it is the social factors that determine the health outcomes. These health-related social factors are the social determinants of health and include the socioeconomic conditions that affect health of a person.

These social determinants of health have rightly been called “the causes of the causes”, which implies that to eliminate a problem, its root causes must be addressed first.Effective care cannot be delivered, if these factors are not taken into consideration.

Health care system is a social determinant of health as well, besides factors like socioeconomic status, education, neighborhood and physical environment, employment and social support networks. Therefore, not just policy makers, healthcare organizations too can work towards addressing the social determinants of community health as agents of change in the community, who can bring about the desired change that is appropriate to the need.Also, they are organizations that work directly with the target population.

Addressing social determinants of health is the most important approach to achieving health equity. As per the CDC, health equity is “when everyone has the opportunity to ‘attain their full health potential’ and no one is ‘disadvantaged”.

Environmental hazards such as exposure to toxic or harmful substances in the air adversely affect the health of several people unless preventive actions are taken. Any intervention to decrease or even eliminate these environmental health threats will therefore reduce the chances of disease. These interventions can be in the form of self-help programs or govt. assistance or policy change. Another way to do this is by altering the behavior of the organization that has endangered the environment etc.

This is what Johns Hopkins Hospital did.

Last week it was reported that two buildings at theJohnsHopkinsHospital, a leading hospital in the US, were evacuated. The reason, a small amount of the tuberculosis bacteria may have been released while being transported, due to a broken vial, which may have exposed people to tuberculosis. The drop occurred in the internal bridge that connects the hospital’s Cancer Research Building 1 to its Cancer Research Building 2, a non-patient area of the hospital. Employees who were in the area when the incident occurred were put in isolation.

These precautionary measures were intended to prevent exposure of the public on the campus to TB, a highly infectious airborne bacterial infection. MDR TB is recognized as a major public health problem.

This is the level of preparedness, all hospitals must aim to achieve because the safety and well-being of the community depend on it.

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA