Denova’s Health Blog

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These 3 Factors Determine Your Health. They Shouldn’t.

At denova Collaborative Healthcare, we often speak about health inequity – the unfair and avoidable differences in health status within the same country and even the same city. There are many issues that impact health inequity, but most can be grouped into three categories: social determinants of health, implicit bias, and lack of diversity in healthcare.


Social Determinants of Health

Social determinants of health include socioeconomic factors that fall outside of the healthcare field, like education, working conditions, and location (living in a food desert, near a highway, or within an area designated for industrial development). 

A startling example of the impact that social determinants of health have on health inequity can be found right here in Arizona, where people living in Phoenix’s 85004 zip code have a life expectancy 14 years shorter than that of their neighbors just 12 miles away in Scottsdale’s 85258 zip code.


Implicit Biases

In addition to social determinants of health, biases within the healthcare system itself result in varied patient outcomes, further worsening health inequity. For example:

  • In 2017, a survey by the Center for American Progress showed that approximately three in 10 transgender people reported at least one incident when providers would not see them because of their gender identity. 
  • The CDC notes that Black women are nearly four times more likely to die from pregnancy and birth complications than their white peers. One study showed that white medical students rated Black patients’ pain lower than that of white patients, an implicit bias that can result in delayed or inadequate medical interventions.
  • UCFS research found that Latino men are significantly less likely to receive optimal treatment for prostate cancer than white men, especially when they lack health insurance. While uninsured non-Latino white men were 37% less likely to receive definitive treatment than those with insurance, uninsured Latinos were 66% less likely to undergo definitive treatment compared to their insured counterparts.

Even a widespread pandemic like the current COVID-19 outbreak disproportionately affects BIPOC communities, which have seen higher rates of infection, severe illness, and death than America’s white population.


Lack of Diversity

The healthcare industry, from insurance companies to providers, is afflicted with a lack of diversity. According to the American Association of Medical Colleges, Black and Hispanic Americans make up just 10.8% of practicing physicians, despite accounting for more than 30% of the U.S. population. The result is an industry-wide inability to consider the needs and viewpoints of an increasingly diverse patient population and a lack of understanding for cultural sensitivities and identities.


Change for the Better

The many contributing factors to health inequity mean that it can only be tackled through a comprehensive, society-wide effort. 

At denova, our staff – from receptionists to providers – is committed to compassionate care, regardless of age, race, religion, sexual identity, or income. We employ a team ready to meet the needs of Arizona’s diverse population. We have offered telehealth services since 2009, reducing some of the hurdles of accessing care, such as time off work and distance to our clinics. We accept all insurance providers, including AHCCCS, and offer cash payments on a sliding scale for those facing financial hardship.

Our promise is to offer equitable care, addressing the unique needs of each individual patient with both dignity and clinical excellence. And while denova is committed to eliminating inequity within its own walls, we will continue to be relentless in advocating for change across the state to make sure all Arizonans can achieve their best health. 

We treat all of you here.

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Amanda Keenhold, LAC

Licensed Associate Counselor

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