Cross-sector support for a policy framework to tackle social determinants of health

This JAMA Forum discusses 4 focus areas developed by a collaborative of more than 40 organizations and experts in health care, social services, and other sectors designed to find ways to support and address social determinants of health with better program coordination and partnerships and novel financing approaches.

Over the last decade, the influence of social conditions on household and public health has featured more prominently in health care practice and policy. Examples range from screening patients for social determinants of health (SDOH) or health-related social needs to several states using federal Medicaid Section 1115 waivers to tackle housing conditions for medically vulnerable populations. Yet, for several reasons, the pace of SDOH initiatives has been slower than many advocates expected.

For one thing, although research on social factors is expanding, it still may be insufficient to justify big investments by government or health systems. Members of many communities are also suspicious of the motives and consequences of health system investment in housing or social services; other skeptics fear that such investment in social factors is ineffective and will divert attention from basic health care needs. Moreover, many health care statutes and administrative procedures are poorly aligned with promoting the cross-sector partnerships and flexible funding streams needed to tackle SDOH.