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Addressing Social Determinants to Improve Patient Care

Ann Intern Med; ePub 2018 Apr 17; Daniel, et al

Understanding and addressing social factors that affect health outcomes can improve care and promote health equity, according to a new position paper from the American College of Physicians (ACP). The paper was drafted by the Health and Public Policy Committee of the ACP, and offers the following policy recommendations:

  • ACP supports increased efforts to evaluate and implement public policy interventions with the goal of reducing socioeconomic inequalities that have a negative impact on health.
  • ACP recommends that social determinants of health and the underlying individual, community, and systemic issues related to health inequities be integrated into medical education at all levels.
  • ACP supports increased 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.
  • ACP supports the adequate and efficient funding of federal, state, tribal, and local agencies in their efforts to address social determinants of health.
  • ACP supports increased research into the causes, effects, prevention, and dissemination of information about social determinants of health.
  • ACP recommends policymakers 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.
  • ACP recommends development of 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.
  • ACP recommends adjusting quality payment models and performance measurement assessments to reflect the increased risk associated with caring for disadvantaged patient populations.
  • ACP recommends increased screening and collection of social determinants of health data to aid in health impact assessments and support evidence-driven decision making.


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. [Published online ahead of print April 17, 2018]. Ann Intern Med. doi:10.7326/M17-2441.

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