Theory vs practice: Should primary care practice take on social determinants of health now? Yes.

Of all ethnic groups in New Mexico, Native Americans have some of the best screening and treatment for diabetes, yet have by far the worst outcomes from that disease—kidney failure, amputations, blindness. High-quality care cannot adequately compensate for decades of low income, low educational achievement, poor nutrition, poor housing, and social marginalization—all social determinants of health (SDH). With appropriate transformation, primary care practices are well-suited to address SDH.