Addressing social determinants of health: Time for a polysocial risk score

What determines health? For decades, researchers have attempted to quantify the exact contribution of social factors, such as income, education, race/ethnicity, and the community environment, to health. The motivation is simple: understanding which social factors most affect health would help prioritize societal investments in those areas. However, most efforts to precisely quantify the influence of individual social determinants of health have failed, largely because the causal pathways are numerous, interconnected, and complex. Most empirical evidence has found that social factors matter in aggregate, but quantifying their individual contributions is difficult. After decades of efforts in this area, it may be time for a new approach.