Socioeconomic Model
Socioeconomic Model (SEM) or Spheres of Influence is a concept designed to better understand the various levels of Influence which affect access to care and health outcome at the individual and social levels
See below for some excellent resources or check out my Blog for a practical discussion on the role of SEM in the candidacy of knee replacement surgeries in Canada
The report by the Healthy People Committee provides a comprehensive source of information on SDoH with the goal of encouraging a safe and healthy population
Committee, S. A. (2010). Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the U.S.
The Center for Disease Control uses SEM to understand and prevent violence. This same model is appliable in health
Centers for Disease Control and Prevention. (2022) The Social-Ecological Model: A Framework for Prevention. Violence Prevention. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html
Exploring the concept of Spheres of Influence and tying them together with SDoH and SEM, health as a concept can be better understood and applied
DeCamp, M., DeSalvo, K., & Dzeng, E. (2020). Ethics and Spheres of Influence in Addressing Social Determinants of Health. Journal of general internal medicine, 35(9), 2743–2745. https://doi.org/10.1007/s11606-020-05973-1
Peer-reviewed article which notes that despite cultural awareness of the impact of SDoH and SEM on individual health, the onus is still overwhelmingly on the individual rather than improving upstream factors
Golden, S. D., & Earp, J. A. (2012). Social ecological approaches to individuals and their contexts. Health Education & Behavior, 39(3), 364–372. https://doi.org/10.1177/1090198111418634
Spheres of influence can be used to understand the role of healthcare providers and how their influence can be restricted or expanded to promote healthy, ethical, and equitable health
Karches, K., DeCamp, M., George, M., Prochaska, M., Saunders, M., Thorsteinsdottir, B., & Dzeng, E. (2021). Spheres of Influence and Strategic Advocacy for Equity in Medicine. Journal of general internal medicine, 36(11), 3537–3540. https://doi.org/10.1007/s11606-021-06893-4
Youtube resource supported by the National Institute of Health to promote awareness and understanding of social inequalities in health
NIH. (2014). Social Inequalities in Health. youtube.com / Social Inequalities in Health. Retrieved October 16, 2023, from https://www.youtube.com/watch?v=roAQHn5rEoQ.
Examining and creating tangible corporate guidelines around spheres of influence for promotion and protection of human rights
Ruggie, J. G., & UN. Special Representative of the Secretary-General on Human Rights and Transnational Corporations and Other Business Enterprises. (2008). Clarifying the concepts of "sphere of influence" and "complicity": Report of the Special Representative of the Secretary-General on the Issue of Human Rights and Transnational Corporations and Other Business Enterprises (United Nations General Assembly Document No. A/HRC/8/16). Retrieved October 20, 2020, from untitled (harvard.edu)
Explaining the relationship between SEM and SDoH on people's physical and psychological wellness to better understand individual and community impacts and responsibilities
Wang, J., & Geng, L. (2019). Effects of Socioeconomic Status on Physical and Psychological Health: Lifestyle as a Mediator. International journal of environmental research and public health, 16(2), 281. https://doi.org/10.3390/ijerph16020281
With physicians and patients in mind, this article by White (2015) addresses SEM and the importance of examining health from a holistic lens beyond the confines of illness. This is an excellent resource for gaining understanding in SEM
White, F.M.M (2015). Primary Health Care and Public Health: Foundations of Universal Health Systems. Medical Principles and Practice. DOI:10.1159/000370197