Meanings and misunderstandings: A social determinants of health lexicon for health care systems
The language of the social determinants of health is currently in vogue in US health care. Yet the same words and concepts, such as social determinants of health and population health, are often used in different ways—sometimes with very different objectives. This, for fans of the later Wittgenstein, is how language works: the meaning of words is in their use. Confusion over health care jargon is nothing new. But misunderstandings over meanings could have important implications as a growing number of health care systems design new interventions to respond to patients’ social circumstances. New collaborations among the health care, public health, and social services sectors—each often arriving with different ways of thinking about social determinants of health and social interventions—would benefit from a shared understanding of the language being used and what it means for achieving their objectives. Clarity would also benefit policymakers exploring (and testing) new payment systems and policies to incentivize greater health care investments in social supports. This is particularly important given the potential unintended consequences of bringing language and information related to patients’ social circumstances into a market‐based health care system.
Alderwick H, Gottlieb LM. Meanings and misunderstandings: A social determinants of health lexicon for health care systems. Milbank Q. 2019. Epub ahead of print. https://doi.org/10.1111/1468-0009.12390.