Social Determinants Matter, But Who Is Responsible?

The health impacts of the environments in which we live—our social determinants of health—are well documented. Clinical care accounts for only about 20 percent of health, while behaviors, physical environment, and social and economic factors determine the rest. The transition to value-based care increasingly requires the clinical setting to address these social determinants of health (SDOH); however, how to tackle these systemic social challenges is less apparent. We surveyed physicians to understand their attitudes toward SDOH and found that although most physicians agree that SDOH matter for patient health, most physicians do not currently believe addressing these social issues are their responsibility. Based on these findings, we discuss a variety of policy implications, including the importance of promoting efforts to help clinical sites address patients’ SDOH without contributing to physician burden; engaging employers and policy makers as key stakeholders in efforts to improve community health; and increasing investment in public health.