Addressing Social Determinants to Improve Patient Care and Promote Health Equity: An American College of Physicians Position Paper

Insights Results

Overview of article

• This position paper describes the stance of the American College of Physicians on the role of social determinants of health, examines the complexities associated with them, and offers recommendations on better integration of social determinants into the healthcare system while highlighting the needs to address systemic issues hindering health equity
  Methods
• This policy paper was drafted by the Health and Public Policy Committee of the American College of Physicians (ACP), which is charged with addressing issues that affect the healthcare of the U.S. public and the practice of internal medicine and its subspecialties. The authors reviewed studies, reports, and surveys on social determinants of health from PubMed, Google Scholar, relevant news articles, policy documents, Web sites, and other sources. Recommendations were based on reviewed literature and input from the ACP’s Board of Governors, Board of Regents, Council of Early Career Physicians, Council of Resident/Fellow Members, Council of Student Members, and Council of Subspecialty Societies and a nonmember expert in the field

Key takeaways/implications

• 9 policy recommendations were proposed to better integrate SDOH into systems and improve health equity: 1) Increase efforts to evaluate and implement public policy interventions with the goal of reducing socioeconomic inequalities that have a negative impact on health; 2) Integrate social determinants of health and the underlying individual, community, and systemic issues related to health inequities into medical education at all levels; 3) Increase interprofessional communication and collaborative models that encourage a team-based approach to treating patients at risk to be negatively affected by social determinants of health; 4) Support adequate and efficient funding of federal, state, tribal, and local agencies in their efforts to address social determinants of health, including investments in programs and social services shown to reduce health disparities or costs to the healthcare system and agency collaboration to reduce or eliminate redundancies and maximize potential impact; 5) Increase research into the causes, effects, prevention, and dissemination of information about social determinants of health. A research agenda should include short- and long-term analysis of how social determinants affect health outcomes and increased effort to recruit disadvantaged and underserved populations into large-scale research studies and community-based participatory studies; 6) Adopt a “health in all policies” approach and supports the integration of health considerations into community planning decisions through the use of health impact assessments; 7) Develop best practices for utilizing electronic health record (EHR) systems as a tool to improve individual and population health without adding to the administrative burden on physicians; 8) Adjust quality payment models and performance measurement assessments to reflect the increased risk associated with caring for disadvantaged patient populations; and 9) Increase screening and collection of social determinants of health data to aid in health impact assessments and support evidence-driven decision making