Assessing social determinants of health in primary care: Liability or opportunity

UMMS Affiliation

Center for Integrated Primary Care; Department of Family Medicine and Community Health

Publication Date


Document Type



Behavioral Medicine | Health Psychology | Health Services Administration | Health Services Research | Integrative Medicine | Medicine and Health | Mental and Social Health | Primary Care | Psychiatry and Psychology


Health care is never boring. It changes rapidly based on political winds, financial models, novel terminology, and biomedical advances. In the past decade, there has been large-scale implementation of integrated health care, routine screening for common behavioral health conditions, and the rollout of alternative payment models in primary care. However, even before these advances have been inculcated as the standard of care, we are now witnessing the implementation of health coaches and recommendations to screen for social determinants of health. Social determinants of health (SDOHs) include nonclinical factors that impact health, such as income, education, and the social the conditions in which people are born, grow, live, work and age. While there is strong evidence that health outcomes are only marginally determined by direct clinical care and largely determined, it is unclear what "system of care" (public health vs. medical care) bears the responsibility of identifying and addressing these issues. Is this really the responsibility and role of primary care? Whether we as a health care system decide that systematically asking about and addressing SDOHs is within our job descriptions remains to be seen. Further research is needed to determine the cost and clinical impact of screening and addressing SDOHs.

DOI of Published Version



Fam Syst Health. 2018 Dec;36(4):550-552. doi: 10.1037/fsh0000377. Link to article on publisher's site

Journal/Book/Conference Title

Families, systems and health : the journal of collaborative family healthcare

Related Resources

Link to Article in PubMed

PubMed ID