Author Affiliations: Department of Family and Community Medicine (Dr Gottlieb) and Center for Health and Community (Drs Gottlieb and Adler), University of California, San Francisco; and Departments of Pediatrics and Public Health, Boston University, Boston, Massachusetts (Dr Sandel).
Despite strong evidence linking patients' social circumstances to their health, little guidance exists for health care practitioners and institutions on addressing social needs in clinical settings. Current approaches to social determinants generally focus on population-level and policy interventions; these overlook individual and clinical innovations within health care that can address patients' social circumstances. This article proposes a framework for how social determinants interventions in the health care system can be construed across 3 tiers—patient, institution, and broader population—and describes ways to collect data and target interventions at these levels.
Gottlieb L, Sandel M, Adler NE. Collecting and Applying Data on Social Determinants of Health in Health Care Settings. JAMA Intern Med. 2013;173(11):1017-1020. doi:10.1001/jamainternmed.2013.560