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Addressing social determinants of health in federal programs

De Lew N, Sommers BD
JAMA Health Forum

Although high-quality, affordable health care is essential to addressing medical conditions when they arise, the strongest predictor of health outcomes in the US is not medical care but rather the broader social context in which people live and work. These social determinants of health, such as economic conditions, housing, nutrition, the environment, transportation, and education, are estimated to account for half of the county-level variation in health outcomes and are a major driver of health disparities. Advancing racial equity and supporting underserved communities is a central priority of the Biden-Harris administration. To improve the health of the US population and dismantle long-standing inequities, a comprehensive federal approach addressing social determinants is now underway.

Many federal health care and public health programs reside within the US Department of Health and Human Services (HHS), including Medicare, Medicaid, the Indian Health Service, and more. Other HHS programs address human service needs, including Temporary Assistance for Needy Families, Head Start, and programs to support people with disabilities. Integrating health services (both medical care and public health) with human services—and vice versa—is a critical step to addressing social determinants of health and improving equitable outcomes. This work is a major priority for the HHS.

The HHS has developed a 3-pronged strategy to address social determinants: (1) better data, (2) improving health and social services connections, and (3) whole-of-government collaborations.

De Lew N, Sommers BD. Addressing Social Determinants of Health in Federal Programs. JAMA Health Forum. 2022;3(3):e221064. doi:10.1001/jamahealthforum.2022.1064

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