Addressing Social Determinants of Health in Challenging Times
July 2026
I was recently on call and a patient with diabetes contacted me about hypoglycemic issues while on insulin. Typically, this is a straightforward problem with easy adjustments and solutions. However, this patient told me that their issue was managing their insulin with no ability to afford food for a number of days at a time. This took me aback. Most of us cannot fathom being in this scenario and I would assume many of us often overlook situations like this happening in our own backyard. Not only was this patient affected, so were her children who I had no idea before this phone call, were facing so many barriers to living healthy lives.
While we may not be overtly in a recession, I think we can all sense the pressures many are facing in our communities and state right now with rising costs for daily needs like gas, food, and housing. If you are like me, you probably only see this as affecting your life in terms of things like investments and not in tangible ways. However, for many of our patients, this affects them firsthand every single day and in the case of this patient, it could mean life or death. Thankfully, our state does have a number of resources for patients like this, but many people, including physicians, are not aware of these programs. While it is important to learn about cutting edge medications, tests, and other advances, sometimes it is equally important to learn about resources to help meet the most basic needs humans face.
The reason I bring up this topic here is because the SDSMA is actively working to help the citizens of our state address these needs. Recently, we made a large donation to Feeding South Dakota. Our association is in a strong spot financially and we see it as our duty to give back to both our members as well as our patients. We hope to continue being a philanthropic organization and donate to similar causes for years to come. In addition, our recent SDSMA Annual Conference was a resounding success. Not only was it well attended, it provided high quality education and growth. This year’s topic was Lifestyle Medicine, a topic I have been passionate about for years now. Through this, we involved our Department of Health and many physicians to discuss not only the tenants of this field, which certainly crosses all specialties, but also educate you all on ways our state can help support patients living healthier lifestyles which we know will lead to significantly better long term outcomes. In our current economic times, this becomes more challenging but makes it even more critical to involve community programs, churches, governmental programs, and other resources to help patients succeed.
Patients do often make the best teachers, and in the case of this patient, she reminded me that sometimes my own patients’ greatest barriers are not a prescription, procedure, or a diagnostic test. Instead, this patient needed to be connected to a social worker, community resources, and reminded of nutritional aspects that will often ascend anything I can do in the exam room. If you have ideas for ways the SDSMA can continue to help give back to our communities, I would welcome any ideas and new partnerships. Social determinants of health can often be more challenging to solve than most disease processes. However, I am thankful we have organizations like the SDSMA and our state health department who partner with physicians to help South Dakotans achieve better health outcomes.
