Which social determinants of health should be considered when selecting tests and planning treatment in clinical decision making?

• A. Access to care, social supports, cost, literacy, and health beliefs when selecting tests and planning treatment.
• B. Only age and sex.
• C. Only laboratory results.
• D. Insurance type and employment status only.

Answer: (B)

When deciding what tests to order and how to plan treatment, you must look beyond clinical data and consider social determinants of health that affect what’s feasible and sustainable for the patient. Access to care determines whether a test can be scheduled, completed, and followed up; social supports influence the patient’s ability to manage complex regimens and attend follow-up visits; cost and insurance coverage affect whether tests and treatments are affordable; health literacy and beliefs shape understanding of instructions and willingness to follow through. These factors directly impact adherence, follow-up, and outcomes, so a plan that explicitly accounts for access, supports, cost, literacy, and health beliefs leads to a more appropriate, patient-centered approach. Narrowly focusing on age and sex or on laboratory results misses these critical determinants, and while insurance and employment status matter, they’re only part of the bigger picture.