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Comment & Response
December 20, 2016

Screening for Social Determinants of Health—Reply

Author Affiliations
  • 1Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
  • 2Office for Community Child Health, Connecticut Children’s Medical Center, Hartford, Connecticut
JAMA. 2016;316(23):2552-2553. doi:10.1001/jama.2016.16925

In Reply In our Viewpoint, we were not arguing against screening for social determinants of health. Rather, our intent was to posit that screening be performed with attention to key tenets, specifically, the importance of performing screening in the context of care coordination, expanding models of such supports, and employing a patient-centered approach.

Dr Bayer and Mr Johns suggest that we challenged screening for social determinants of health by raising ethical concerns about detecting issues without ensuring appropriate referral to services. This is not a novel concept, as the World Health Organization in 1968 identified treatment as a key principle of medical screening1; others have also reinforced this concept.2 We agree with the need for physicians to understand their patients’ circumstances.