What social determinants will cause ethical challenges in geriatric care? Comments from South Africa

Abstract

Background. Social determinants are defined as those non-medical factors that influence health. Their influence is especially evident in vulnerable communities such as the geriatric community. What is not confirmed yet is which social determinants will cause ethical challenges in geriatric healthcare in South Africa. Objectives. This study first identified which social determinants influence geriatric care. The study then ascertained which of these social determinants gives rise to ethical challenges in geriatric care. Methods. Twenty statements were identified from the literature review that were grouped into three indexes, focusing respectively on a general view on public health and social determinants, social determinants influencing geriatric people’s health, and the consequences of social determinants on geriatric people’s health. The ranking was based on presenting the statements by means of a five-point Likert-scale. Results. The ranking of statements confirmed the generally accepted view that social determinants impact on the geriatric people’s health. The responses to the statements were an additional confirmation that quality of healthcare services and access to healthcare services influence geriatric care and raise ethical challenges. Matters such as corruption, limited resources and the current COVID-19 pandemic contribute to the influence of social determinants and the expected but failed ethical behaviour towards the geriatric community. Conclusions. One of the causes of vulnerability in the geriatric community is that there are ongoing social factors that impact negatively on health, of which healthcare provision and the quality of healthcare provision are important contributing factors. These factors contribute towards ethical challenges in healthcare for the geriatric community.