Our health care system is waking up to the fact that the health of individuals and families does not depend solely on good coverage and good medical care; it also requires us to address social and other factors that are major contributors to a person’s physical and mental well-being. That’s why more and more clinics are screening incoming patients for challenges in areas ranging from housing conditions, nutrition, access to transportation, and even their ability to afford utilities. It’s why the American Academy of Pediatrics urged its members not only to screen all patients for food insecurity but to refer parents to appropriate agencies. It is also why some hospitals, to reduce readmissions, have brought organizations like Health Leads into their discharge planning to connect patients with social services.
There has been much less progress, unfortunately, in realigning the health care system itself to reflect the importance of social determinants. Even taking into account relatively high health care prices, the United States remains an outlier among industrialized countries in the proportion of gross domestic product spent on medical care relative to social services, despite research indicating that countries (and even individual US states) with more balanced spending patterns have significantly better health outcomes.
What is needed to get our system to alter direction? A number of things, but some basic steps are needed to create the environment for change.
[For more on this story by STUART BUTLER, PHD, go to https://newsatjama.jama.com/20...erminants-of-health/]
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