Insights from older adults in North Carolina: Understanding social determinants of health through focus groups.

Older adults experience unique social determinants of health (SDoH) that profoundly impact their health outcomes, but these factors are often overlooked in their healthcare. SDoH are the socioeconomic conditions in which people live, which drive over 60% of health outcomes. This qualitative study aimed to understand older adults' perspectives on the most significant SDoH in their lives, as well as what their healthcare providers may be overlooking. We conducted focus groups with individuals aged 55 and older across three North Carolina counties (Caswell, Chatham, and Orange Counties) to assess how different community contexts influence SDoH. Financial stability and paying for healthcare were discussed similarly in all counties, as were provider overburdening, healthcare center inefficiency, and insurance company influence in limiting healthcare access. Caswell and Chatham participants discussed education access to navigate healthcare systems, whereas Orange and Caswell counties discussed transportation and housing concerns. Additionally, Orange and Chatham participants described senior socialization for health. All groups felt that time and good relationships with providers were essential for positive outcomes and facilitating SDoH discussion. These insights from the voices of older adults shed light on both common and diverse needs of these individuals across various communities and can guide healthcare and policy initiatives to improve health outcomes in this population.