Social Determinants, Health Literacy Factor in Noncommunicable Diseases, Subsequent Infections

Jacinda Abdul-Mutakabbir, PharmD, MPH, assistant professor of Clinical Pharmacy and antimicrobial resistance researcher at the University of California San Diego, points to social determinants and a lack of health literacy as two major causes to why many individuals are not accessing medical care or getting a full understanding of their health.

In terms of social determinants, it could be that individuals are dealing with poverty, being uninsured or underinsured, have transportation limitations, or other challenges that prevent them from engaging with health care providers. Secondarily, for those who might be able to see providers, there is still the possibility that they might not have the knowledge to ask the right questions to their providers or comprehend what is being told to them.

Too often, patients only go to a provider after they have started to feel symptoms, and Abdul-Mutakabbir says at that point it can be too late. This can lead to noncommunicable disease (NCD) and makes them more at risk for serious infections.

She points to this being an issue in both low- and middle-income countries as well as some areas within the US. For individuals with NCD, they then can be dealing with acute issues that require hospitalization and in turn puts them at a greater risk for healthcare-acquired infections.

Abdul-Mutakabbir studied the syndemic relationship between NCD and multidrug resistant (MDR) infections. This became the basis for her study, which was recently published in the journal Infectious Diseases and Therapy.

She sees prevention of disease and infection as paramount pieces in health care that often get overlooked. “We need to focus on prevention as much as we focus on outcomes and treatment.”

From a clinical management standpoint, Abdul-Mutakabbir believes there are challenges in applying what is learned in these types of studies that is translated into clinical practice. She says we need to link the scientific findings to the participants’ demographics.

“There's really a lack, I feel, of translational data, so data that goes from the bench and connects the clinical outcomes,” Abdul-Mutakabbir said. “You'll see some benchtop research where they connect what they see on the bench with how it is that the patients may have fared clinically. Now we have to go that extra step and then also include the social demographic information. So, if you can say we collected these isolates, this is what we saw on the bench. This is the potential connection that we may see biologically. This is how the patient performed with this drug therapy clinically, and these were the patients that were most represented amongst those with the infections. These were the comorbid disease states that they had. It allows for us to have that continuous line of connection.”

This is the second installment of the interview. To watch the first episode go here.