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Comment & Response
December 20, 2016

Screening for Social Determinants of Health

Author Affiliations
  • 1Columbia University, Mailman School of Public Health, New York, New York
JAMA. 2016;316(23):2551-2552. doi:10.1001/jama.2016.16922

To the Editor Dr Garg and colleagues1 provided a challenge to those who believe that screening for social determinants can improve population health. They asserted that unlike conventional clinical screening, “screening for social determinants can detect adverse exposures and conditions that typically require resources well beyond the scope of clinical care. Screening … without the capacity to ensure referral and linkage to appropriate treatment is ineffective and, arguably, unethical.” Because physicians may be powerless to address the social factors that make individuals vulnerable to illness, such screening can backfire by creating “expectations that, if unfulfilled, could lead to frustration in patients and physicians alike.” The authors warned that targeting individuals based on age, education, or minority status may reinforce stereotypes and “stigmatize the screening process.”