Social Determinants of Health: Same Treatment, Different Outcomes

Identical clinical plan for both patients: same diagnosis, same prescribed daily medication, a follow-up clinic visit every 4 weeks, and the same recommended dietary change. Only their surrounding life resources differ below.

Simulation speed 1×

Patient A — resources

Transportation access 60

Financial stability 60

Housing stability 60

Food access 60

Visits

–

Meds taken

–

Diet score

–

Outcome

–

Patient B — resources

Transportation access 60

Financial stability 60

Housing stability 60

Food access 60

Visits

–

Meds taken

–

Diet score

–

Outcome

–

How this model works

Every week, each patient rolls against three adherence checks — take the daily medication, keep the follow-up visit (every 4th week), make the grocery trip for the prescribed diet — but the odds of succeeding at each are set by that patient's transportation, financial, housing and food-access sliders, not by the treatment plan, which is identical for both. A weighted blend of the three adherence rates then drives weekly change in an outcome score: the same clinical "ceiling" per week, scaled by how much of the plan the patient could actually complete.

Transportation mainly gates the follow-up visit.
Financial stability mainly gates medication and contributes to visits and diet.
Housing stability supports a routine for taking medication reliably.
Food access mainly gates the dietary change.

Watch the two outcome-score lines split apart even though the doctor wrote the exact same prescription for both — the gap is produced entirely by which patient could follow through.

Patient A Patient B Adherence success Adherence missed

Week 0 / 26

A outcomeB outcome

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