Abstract
Purpose: Public health leaders have advocated for clinical and population-based interventions to address the social determinants of health (SDoH). The American Academy of Family Physicians has worked to support family physicians with addressing the SDoH. However, the extent that family physicians are engaged and the factors that influence this are unknown.Methods: A survey was used to identify actions family physicians had taken to address the SDoH and perceived barriers. Physician and community characteristics were linked. Ordinal logistic regression was used to identify factors associated with engagement in clinical and population-based actions, separately.Results: There were 434 (8.7%) responses. Among respondents, 81.1% were engaged in at least one clinical action, and 43.3% were engaged in at least one population-based action. Time (80.0%) and staffing (64.5%) were the most common barriers. Physician experience was associated with higher levels of clinical engagement, lower median household income was associated with higher levels of population-based engagement, and working for a federally qualified health center (FQHC) was associated with both.Conclusions: The study provides preliminary information suggesting that family physicians are engaged in addressing the SDoH through clinical and population-based actions. Newer family physicians and those working in FQHCs may be good targets for piloting clinical actions to address SDoH and family physician advocates may be more likely to come from an FQHC or in a lower socioeconomic neighborhood. The study also raises questions about the value family physicians serving disadvantaged communities place on clinical interventions to address the SDoH.
Highlights
The social determinants of health (SDoH) have a substantial impact on population health, contributing more than behavior, clinical care, and the environment.[1,2] SDoH are the primary driver of health inequities.[3]Many organizations have adopted priorities for addressing the SDoH in response to their large impact on population health and comparatively low level of investment.[4,5]The American Academy of Family Physicians (AAFP) made health equity a strategic priority in 2017.6 It has positioned family physicians as important champions for health equity because they more often provide health a Kevin A
Participants were asked, ‘‘Which of the following have you engaged in to address social determinants of health?’’ Statements included the following: written or spoken with elected officials to support public policies aimed at addressing SDoH; provided testimony at a hearing to support public policies aimed at addressing SDoH; and were involved in community health needs assessment, community health improvement planning (CHIP), or other collaborative initiatives aimed at improving community health
At the population-level 25.8% had written or spoken with elected officials to support public policies aimed at addressing SDoH, 5.5% had provided testimony at a hearing to support public policies aimed at addressing SDoH, and 31.6% were involved in community health needs assessment, CHIP, or other collaborative initiatives aimed at improving community health
Summary
The social determinants of health (SDoH) have a substantial impact on population health, contributing more than behavior, clinical care, and the environment.[1,2] SDoH are the primary driver of health inequities.[3]Many organizations have adopted priorities for addressing the SDoH in response to their large impact on population health and comparatively low level of investment.[4,5]The American Academy of Family Physicians (AAFP) made health equity a strategic priority in 2017.6 It has positioned family physicians as important champions for health equity because they more often provide health a Kevin A. The social determinants of health (SDoH) have a substantial impact on population health, contributing more than behavior, clinical care, and the environment.[1,2] SDoH are the primary driver of health inequities.[3]. Many organizations have adopted priorities for addressing the SDoH in response to their large impact on population health and comparatively low level of investment.[4,5]. The American Academy of Family Physicians (AAFP) made health equity a strategic priority in 2017.6 It has positioned family physicians as important champions for health equity because they more often provide health a Kevin A.
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