Survey: Majority of Texans say lawmakers should prioritize social determinants of health

In case you missed it, an Episcopal Health Foundation (EHF) survey came out earlier this month which indicated majority support among Texans for state lawmakers to prioritize Social Determinants of Health as they expand access to health care.

As defined in the report, Social Determinants of Health (SDOH) are the non-medical “conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” Specifically, SDOH can refer to quality of education, employment stability, residential status, and many other social factors that influence the public’s health and health outcomes.


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The EHF “Texas Social Determinants of Health Survey” was conducted by phone from October 10 – November 19, 2019 among a random representative sample of 1,200 adults age 18 and older living in Texas. The survey asked respondents to rate the importance of a number of factors that could influence health.

Residents ranked several social determinants of health as “high” on the list, with a majority ranking every item on the list as “essential” or “very important.”

62% of respondents answered that improving the economy and availability of jobs should be a top priority for the state legislature as they look for policy solutions to enhance health outcomes. 60% said that reducing air, water or chemical pollution should be a top priority, with 59% saying the same for reducing crime and improving neighborhood safety and improving public schools.

COVID-19 is clearly showing what Texans already know: the state needs to address underlying, non-medical conditions that have a dramatic impact on their health,” said Elena Marks, EHF’s president and CEO. “Low-income and minority communities are more likely to catch the virus in the first place and more likely to get sicker and die if they do catch it. All of that goes back to social, community, and economic conditions — not medical care.”

Indeed, the survey results also indicated that low-income Texans were more likely than those with higher incomes to say that addressing SDOH should be a top priority for lawmakers.

On top of support for addressing SDOH, researchers also found widespread support for attempting for improve health outcomes by looking at non-medical factors. 66% of respondents said that Texans would be healthier if the state spent more money on non-medical factors. By contrast only 29% said the state shouldn’t invest in non-medical factors.

According to the researchers, women, young adults between ages 18-29, and low-income Texans were the groups most likely to associate more state spending on non-medical factors with better health.

These numbers, along with the disparities highlighted by COVID-19, should spark important discussions by state leaders on how they can address underlying causes of poor health that have nothing to do with going to a doctor or hospital,” said Marks. “So many Texans face a range of social and economic conditions that conspire against their health. We have to change the conversation to improving health, not just health care in Texas.”