The social determinants of health — moving beyond screen-and-refer to intervention

The notion that clinicians should consider intervening to address social needs triggers resistance of many varieties, including objections that clinicians are inadequately equipped to fill this role. But clinicians are in fact uniquely equipped to address particular social needs — indeed, some resources can only be unlocked with their input. It is therefore the responsibility of clinicians, and by extension health systems, to understand the unique power they hold with regard to social care — a power that extends beyond screening and referral to on-the-spot intervention. Although this discretionary power should not be overstated (higher-level structural change is undoubtedly necessary), health systems have historically understated and underutilized their power to effect positive social change in their patients’ worlds.