Hilary Daniel, BS; Sue S. Bornstein, MD; Gregory C. Kane, MD; for the Health and Public Policy Committee of the American College of Physicians (*)
Financial Support: Financial support for the development of this position paper comes exclusively from the ACP operating budget.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2441.
Requests for Single Reprints: Hilary Daniel, BS, American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001; e-mail, firstname.lastname@example.org.
Current Author Addresses: Ms. Daniel: American College of Physicians, 25 Massachusetts Avenue NW, Suite 700, Washington, DC 20001.
Dr. Bornstein: 3111 Beverly Drive, Dallas, TX 75205.
Dr. Kane: Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107.
Author Contributions: Conception and design: H. Daniel, H.E. Gantzer, T.L. Henry, J.D. Lenchus, L. Viswanathan, A.M. Azah.
Analysis and interpretation of the data: H. Daniel, J.K. Carney, H.E. Gantzer, B.R. Nalitt, L. Viswanathan.
Drafting of the article: H. Daniel, G.C. Kane, J.D. Lenchus, B.M. McCandless.
Critical revision of the article for important intellectual content: H. Daniel, G.C. Kane, J.K. Carney, H.E. Gantzer, T.L. Henry, J.D. Lenchus, B.M. McCandless, L. Viswanathan, C.J. Murphy, A.M. Azah.
Final approval of the article: H. Daniel, S.S. Bornstein, G.C. Kane, J.K. Carney, H.E. Gantzer, T.L. Henry, J.D. Lenchus, J.M. Li, B.M. McCandless, B.R. Nalitt, L. Viswanathan, C.J. Murphy, A.M. Azah, L. Marks.
Administrative, technical, or logistic support: H. Daniel, S.S. Bornstein, G.C. Kane.
Collection and assembly of data: H. Daniel, T.L. Henry.
Social determinants of health are nonmedical factors that can affect a person's overall health and health outcomes. Where a person is born and the social conditions they are born into can affect their risk factors for premature death and their life expectancy. In this position paper, the American College of Physicians acknowledges the role of social determinants in health, examines the complexities associated with them, and offers recommendations on better integration of social determinants into the health care system while highlighting the need to address systemic issues hindering health equity.
Appendix Table. Social Determinants of Health and Health Outcomes*
…an individual who lacks housing (without regard to whether the individual is a member of a family), including an individual whose primary residence during the night is a supervised public or private facility (e.g., shelters) that provides temporary living accommodations, and an individual who is a resident in transitional housing. A homeless person is an individual without permanent housing who may live on the streets; stay in a shelter, mission, single room occupancy facility, abandoned building or vehicle; or in any other unstable or non-permanent situation.
…[look] at health from a broad perspective that considers social, economic, and environmental influences; [bring] community members, business interests and other stakeholders together, which can help build consensus; [acknowledge] the trade-offs of choices under consideration and [offer] decision makers comprehensive information and practical recommendations to maximize health gains and minimize adverse effects; [put] health concerns in the context of other important factors when making a decision; and [consider] whether certain impacts may affect vulnerable groups of people in different ways.
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Daniel H, Bornstein SS, Kane GC, for the Health and Public Policy Committee of the American College of Physicians. Addressing Social Determinants to Improve Patient Care and Promote Health Equity: An American College of Physicians Position Paper. Ann Intern Med. 2018;168:577–578. doi: 10.7326/M17-2441
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Published: Ann Intern Med. 2018;168(8):577-578.
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