Which of the following is NOT a barrier associated with social determinants of health (con SDOH)?

• A. Time
• B. Perception of judgement
• C. Inconsistency between patients
• D. Health literacy

Answer: (D)

The key idea here is distinguishing external barriers created by social conditions from a patient's own abilities that can influence care. Time constraints are a barrier because socioeconomic realities—like work schedules, transportation issues, and caregiving duties—limit when people can access services. Perception of judgement is a barrier since fear of stigma or feeling judged can deter people from seeking care or fully sharing information. Inconsistency between patients represents a barrier to care continuity and clear communication, often arising from misaligned expectations or fragmented care across settings.

Health literacy, however, is about the patient’s capacity to obtain, understand, and use health information. It’s a personal-resource factor that can influence how easily someone engages with healthcare, but it isn’t, by itself, a barrier created by social determinants. It can be addressed through clear communication, plain-language materials, and teach-back techniques, reducing its impact. So, among these, health literacy is not a barrier driven by SDOH in the same way the others are.