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Insights from NC Seniors: Understanding Social Determinants of Health through Focus Group Analysis (2024)

Undergraduates: Pavitra Madala, Claire Evans, Lauren Bedard


Faculty Advisor: Lindsay Wilson
Department: UNC Division of Geriatric Medicine


Seniors experience unique social determinants of health (SDoH) that profoundly impact their health, but these factors are often overlooked in their healthcare. SDoH are the socioeconomic conditions in which people live, encompassing factors such as financial stability, education, healthcare access, and social supports. SDoH have been reported to drive over 60% of a person’s health outcomes, but efforts to incorporate SDoH assessment in healthcare have been challenging and often overlook important factors in diverse communities. Seniors, especially those residing in diverse regions, may encounter distinct SDoH that impact their health and healthcare utilization differently. This qualitative study aimed to explore the lived experiences of seniors and understand what they consider the most significant SDoH in their lives. We conducted focus groups with seniors across three counties in North Carolina (Caswell, Chatham, and Orange Counties) to assess how different community contexts may influence SDoH. We found that financial stability and ability to pay for healthcare was discussed in all counties. Groups from all counties also described challenges in healthcare access due to excessive burden on providers, healthcare center inefficiency, and insurance company influence on healthcare systems. Caswell and Chatham participants described the importance of education access for navigating the healthcare system, whereas Orange and Chatham participants described the importance of senior socialization for health. These insights from the perspectives and voices of seniors shed light on both common and diverse needs of seniors in different communities and can guide future healthcare and policy initiatives to improve health outcomes in this population.