Addressing Social Determinants of Health in the American Landscape

Social determinants of health (SDOH) have gained significant attention in recent years. A growing body of research shows that a person’s health is influenced by a large number of non-genetic factors, most of which operate outside the realm of health care and are directly attributable to socio-economic conditions. In the U.S., clinical and economic motivations have spurred health care providers, health insurance companies, local governments, and community-based organizations to take action to address SDOH. The fragmented structure of the healthcare industry has, on the one hand, stimulated innovation and experimentation. On the other hand, the lack of standardized measures to capture the effectiveness and efficiency of these interventions and the lack of loci to share information about best practices impede the identification and duplication of successful solutions. In this technical note, we describe the main players and their roles in the SDOH ecosystem, as well as the obstacles that hinder the development of successful, large-scale solutions. The note shines a light on the limitations of the current approach and highlights the potential of the U.S. SDOH ecosystem to succeed in addressing these important determinants of population health.