“May I ask you something” :Understanding social determinants in health

The term ‘social determinants of health’ suggest that well-being of an individual is strongly related to the environment where he/she grow and work. These determinants of health lie outside the domain of hospital, for instance, unemployment and poverty. It is hence, crucial to focus on determinants of health to overcome the health inequity among the disadvantaged population.

An integration of various health services is vital to improve the health of a community. To integrate different skills for the benefit of the community, doctors need to think beyond their role of providing treatment for a disease. For me, the larger picture is to combine the expertise of different health professionals for the benefit of the community. The word “benefit,” from my opinion, shouldn’t be limited to saving one individual’s life or treating just a diseases at one point of time . Thus, the treatment approach should be holistic and should  include empathy and examining the social factors in combination  . Further, the treatment plan must involve the community where people are empowered to understand their health.

Few years back ,my home in Tripura India, one beautiful morning, a poor, daily wage labourer came to me with an old bag in his hand. With a shaking voice, he said –”may I ask you something.” I replied, “Yes, you can, what’s the matter?” “He showed me a 200 ml bottle, which was somewhat half filled. With tears in his eyes, he said, “My child has been suffering from a fever since last night, and I am in a dilemma; should I use this old bottle of medicine?” I said, “Thank you for coming here, and I appreciate your willingness to visit me today.” I added, “These are antibiotics and which one should not use randomly or without reason.”

“Well, the boy doesn’t need them for now.”- I said and  called the nearby pediatrician . I  advice  him to go and get the proper medication. His child got cured and all thanks to his father for his timely concern. On a sweet note, the incident itself taught me a key lesson of health promotion that patients are part of the community and they are eager to know about their dilemma. They may be uneducated and poor but want to seek best for their children like you and me. One of a thing currently lacking is a place where they can ask without fear and without being judged -“May I ask you something………..”.