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Focus on Quality Transformation webinar series

Part 1: Medical Legal Partnership 101

Quarterly Claims and Operations Meeting

Part 2: Medical Legal Partnership Funding/Screening

Part 3 Medical Legal Partnership Immigrants and Healthcare

Social Determinants of Health
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What are Social Determinants of Health?

Healthy People 2020 definition

Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. [i]

World Health Organization definition

The social determinants of health (SDH) are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.[ii]


Breakdown of the Social Determinants of Health

Several studies have shown a direct correlation between where a child lives and his or her future economic opportunities as an adult. Social determinants include factors such as where you live, access to healthy foods, social support, and education level. The graphic below lists some examples of factors that impact health outcomes. 



Why Are Social Determinants of Health Important?

A person’s health is determined by more than just access to health care. Social and behavioral factors contribute more than 60 percent of an individual’s health status. Research shows that health behaviors such as smoking, and diet and exercise are most determinants of premature death. Whether someone is able to engage in healthy behaviors is largely determined by a range of social, economic, and environmental factors.[i]


Impact on Health Equity

Health disparities are differences in health outcomes that are closely linked with social, economic, and environmental disadvantage. These are differences that not only exist due to differences in quality of health care, but systemic issues that are linked to the social determinants of health. Health equity can be achieved when all populations of people achieve their highest level of health. This will require communities and decision makers to make broad population-based approaches to tackle disparities.


Why Should SDOH Matter to Health Centers


Community health centers (CHCs) can play a key role in addressing social determinants of health given that they serve at-risk and underserved communities with broad needs. In order to better serve the most vulnerable populations, health centers need to properly identify, track, and assess the social and economic factors such as housing and income stability to better serve their patients. The National Association of Community Health Centers (NACHC) and other primary care associations partnered to create a tool that health centers can utilize assess and address the social determinants of health. The tool, Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE), has entered into the pilot phase and is collaborating with four major EMR vendors to build the tool into the EMR interface.  The information collected using PRAPARE will be critical as health centers are anticipating a new payment model based on value and quality of care, and less on quantity. In the wake of payment reform, it is imperative health centers take action in understand their patient population to ensure proper services are rendered to address the overall factors impacting health.