Social determinants of health framework supports healthier outcomes.

Author:Evans, Tracy Wareing
Position:Director's memo - Column

Social determinants of health (SDOH), "whole family" or "2 Gen" approaches, and population-level decision-making are key buzz words in the field today. The shared objective that each of these ideas embodies--whether you view it from the health care lens or human service perspective--is a desire for a more holistic approach that gets at underlying root causes and intervenes earlier, reducing more protracted social and health issues.

While it is not a new idea that there is value in having programs that serve the same people talking, coordinating care, and working to solve problems earlier, applying a SDOH frame to these integrated efforts is a paradigm shift, especially when coupled with modern technology and business platforms. At their core, these movements are driven by the idea that cost-effective social interventions--not just medical ones--drive healthier outcomes for families and communities.

Both sectors understand that many health problems are prompted by poor nutrition, unhealthy living conditions, persistent social stressors, and other "determinants" that are more about our living environment and less about traditional medical models. On the health care side, new payment and service delivery reform mechanisms including, but not limited to, requirements for hospitals to conduct regular community assessments and reduce hospital readmissions, are driving the heightened use of population-based data to understand who is coming through the doors. In human services, knowledge of neuroscience, trauma-informed care, and behavioral economics is shaping more effective engagement strategies with clients before more government contact and longer-term involvement with families are needed. In both sectors, evidence-based program design is setting new standards and methods for how policy and practice is developed, and how outcomes are valued and measured. Focused efforts at all levels of government to share data and create interoperable systems undergird each of these trends.


In essence, the social determinants frame is helping us ask the same questions of health care patients as we do people seeking social service supports. If we can coordinate our work better across re-purposed programs and existing systems touching the same people, as well as provide the opportunity for every person to serve as a catalyst in his or her own care, then we have a better chance of creating pathways to sustainable, population-based health and...

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