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Internists Say Social Determinants of Health Play Role in Improving Patient Care and Promoting Health Equity

Washington, D.C. April 17, 2018 -- The American College of Physicians (ACP) published a paper today in the Annals of Internal Medicine that examines ways to reduce health care disparities. Addressing Social Determinants to Improve Patient Care and Promote Health Equity provides a set of recommendations aimed at improving patient care and health outcomes, and overcoming the special challenges associated with adverse conditions in which people are born, grow, work and live.

Social determinants of health are non-medical factors that can impact an individual’s overall health and health outcomes. These include conditions that shape a patient’s daily life, such as income, social status and education, their physical environment including access to safe water and clean air; the safety and conditions of their workplace and home; employment opportunities and social support networks, and access to health services.

Health disparities, often rooted in social, economic, and environmental factors, can influence an individual’s health. On average, there is a 15 year difference in life expectancy between the most advantaged and disadvantaged citizens. While addressing social determinants of health alone may not always result in better health care outcomes, it is a critical step forward in solidifying physicians’ roles as advocates for patients.

“Taking a closer look at social determinants of health can help us better understand and address the social factors that have an impact on patient health,” said Jack Ende, MD, MACP, president, ACP. “It’s important that physicians and other medical professionals recognize and account for social determinants of health to create a more comprehensive approach with our patients. Moreover, such an approach can to help eliminate significant health inequalities often associated with social determinants of health, such as homelessness, food insecurity, and mental health stressors such as domestic violence or social isolation.”

Promoting health equity and reducing significant health disparities is a longstanding goal of ACP. In order to reduce our country’s sizable health disparities, ACP’s paper calls for awareness of social determinants of health to be incorporated into medical education at all levels—from medical school to residency and continuing medical education as well—to help all patients get the care they need, not just a select few.

ACP recommends increasing awareness of social determinants of health through increased funding of federal, state, and local programs that address social determinants of health, including investments in programs and social services, and focusing more research on the causes and effects of social determinants of health. Additionally, ACP urges Congress and the administration to implement policies that address the socioeconomic and environmental inequalities that significantly impact patient health, with an increased focus on wellness and prevention.

“A greater focus on social determinants of health can enable physicians to become stronger advocates for patients and to help reduce negative health outcomes that are often associated with social determinants of health,” said Dr. Ende.

ACP’s evidence-based public policy positions are based on reviewed literature and input from the ACP's Board of Governors, Board of Regents, Council of Early Career Physicians, Council of Resident/Fellow Members, Council of Student Members, and Council of Subspecialty Societies and nonmember experts in the relevant field. This paper was developed by ACP's Health and Public Policy Committee, which is charged with addressing issues that affect the health care of the American public and the practice of internal medicine and its subspecialties.

About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.