Lifestyle Medicine Core Competencies: 2025 Update.

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

Structural Justice Ethics in Health Care

Disparities in Vision Health and Eye Care: Where Do We Go from Here?

Academic health centers (AHCs) in the United States have had a leading role in educating the medical workforce, generating new biomedical knowledge, and providing tertiary and quaternary clinical care. Yet the health status of the U.S. population lags behind almost every other developed world economy. One reason is that the health care system is not organized optimally to address the major driver of health status, the social determinants of health (SDOH). The United States' overall poor health status is a reflection of dramatic disparities in health that exist between communities and population groups, and these are associated with variations in the underlying SDOH. Improving health status in the United States thus requires a fundamental reengineering of the health delivery system to address SDOH more explicitly and systematically. AHCs' tripartite mission, which has served so well in the past, is no longer sufficient to position AHCs to lead and resolve the intractable drivers of poor health status, such as unfair and unjust health disparities, health inequities, or differences in a population's SDOH.AHCs enjoy broad public support and have an opportunity-and an obligation-to lead in improving the nation's health. This Perspective proposes a new framework for AHCs to expand on their traditional tripartite mission of education, research, and clinical care to include explicitly a fourth mission of social accountability. Through this fourth mission, comprehensive community engagement can be undertaken, addressing SDOH and measuring the health impact of interventions by using a deliberate structure and process, yielding defined outcomes.

Examining Social Determinates of Health in Adult Sickle Cell Disease Patients

Introduction

Geospatial analysis of patients' social determinants of health for health systems science and disparity research.

Identify areas of consensus on integrating lifestyle medicine (LM) into primary care to achieve optimal outcomes. Experts in both LM and primary care followed an a priori protocol for developing consensus statements. Using an iterative, online process, panel members expressed levels of agreement with statements, resulting in classification as consensus, near consensus, or no consensus. The panel identified 124 candidate statements addressing: (1) Integration into Primary Care, (2) Delivery Models, (3) Provider Education, (4) Evidence-base for LM, (5) Vital Signs, (6) Treatment, (7) Resource Referral and Reimbursement, (8) Patient, Family, and Community Involvement; Shared Decision-Making, (9) Social Determinants of Health and Health Equity, and (10) Barriers to LM. After three iterations of an online Delphi survey, statement revisions, and removal of duplicative statements, 65 statements met criteria for consensus, 24 for near consensus, and 35 for no consensus. Consensus was reached on key topics that included LM being recognized as an essential component of primary care in patients of all ages, including LM as a foundational element of health professional education. The practice of LM in primary care can be strengthened by applying these statements to improve quality of care, inform policy, and identify areas for future research.

Advancing racial justice in patient care encounters—yes, we can!

Lifestyle Medicine emphasizes evidence-based lifestyle changes to address chronic conditions Yet, concerns have emerged regarding its ability to address broader social determinants of health (SDoH). This study examines how family physicians' perceptions of SDoH relate to their use of lifestyle medicine competencies. This cross-sectional survey was administered to 5770 family physicians. Participants rated the importance of LM core competencies and the impact of community conditions on patient health. Data analysis involved descriptive statistics, factor analysis, regression models, and t-tests. This study encompassed 447 responses. The findings revealed that while respondents recognized the effect of certain SDoH, such as access to unhealthy food (89%), alcohol (86%), and tobacco (83%), they showed less awareness of factors like racism and discrimination (53%), and access to parks (56%) or education (60%). Gender and the level of social deprivation in their area were significant factors influencing respondents' perception of SDoH impact. Additionally, those who valued and used lifestyle medicine core competencies were more likely to acknowledge the influence of SDoH on patient health. Our findings suggest that comprehensive education on SDoH, especially with a focus on community aspects, is crucial across all levels of medical training to address this gap and ensure equitable care.

Significance. Analyzing the complex impact of social determinants on population health is extremely important for methodological development of strategies on public health improvement. The purpose of the study was to develop recommendations on incorporating social determinants of health into the strategy development methodology for public health improvement. Material and methods. Desk research: analysis of foreign and Russian scientific literature related to the introduction of the term “social determinants of health” as a methodological basis for developing strategies on public health improvement on the basis of international research (the search was conducted against Scopus and Pubmed online databases using the keyword “social determinants of health”). An online quantitative survey and 2 focus groups were conducted as well. Results. Social determinants of health refer to broad categories of causes, factors and resources that have a direct and indirect impact on public health. The components of the social determinants of public health include economic stability in society, access to education, infrastructure and living environment, as well as a social context and inclusiveness of society in which people live. Taking into account the impact of social determinants on public health in planning and delivering medical services is still a novelty in the medical scientific discourse as well as care delivery practice in our country. The study results indicate a high potential of using the term “social determinants of public health” as a methodological basis for developing strategies to improve public health and show that health managers and doctors can have a greater influence on access to health services and educational information in the field of public health, as well as norms and values of society that contribute to a widespread and cultural imprinting of behavioral practices related to health maintenance. There is a lack of high quality, multidimensional and comprehensive screening tools for social determinants of public health. In this regard, there is a need to develop a new integral indicator “the index of quality evaluation of social determinants” to be introduced into the practice of public health evaluation. Scope of application. The authors propose recommendations for health authorities and attending physicians to develop strategies on improving public health, with due regard to the social construct of “social determinants of health”.

Color lines: Disparities in pharmacy treatment, education, and practice

Social determinants of health (SDH) contribute to nearly 50% of health outcomes; however, SDH data collection is inconsistent in clinical practice. This study used mixed methods to evaluate health care professionals' perceptions of universal SDH screening at an academic medical center by surveying physicians, advanced practice providers, nurses, social workers, case managers, pharmacists, and administrators. An electronic survey assessed SDH screening practices, prioritization of SDH domains, disciplines to perform screening, and attitudes and barriers to universal screening. Likert-scale responses were dichotomized and compared disciplines with proportions tests. Qualitative interviews identified themes and elaborated survey findings. Participant discipline was the primary predictor variable. Of 193 survey participants (62.5% response rate), most were physicians (31%) or social workers (22%). Participants overwhelmingly reported using SDH information in patient care (93%), and social workers as the most appropriate role for screening (95%). Most respondents (75%) believed health literacy is important, but 40% reported routine assessment. Housing status (73% vs. 53%) and financial strain (62% vs. 48%) followed similar patterns. SDH screening barriers included lacking resources to address identified needs (51%), time to ask (45%), support staff to ask (33%), and training in responding to identified needs (28%). Social workers cited barriers less often than non-social workers (P < 0.001). Qualitative interviews (n = 16) supported survey findings and described barriers including lack of time, resources, standardized approaches, and professional burnout. Health care professionals support universal SDH screening while highlighting the need to address implementation barriers. Strategies should leverage social work expertise and optimize SDH data accessibility for all providers.

Perioperative Medicine: What the Future Can Hold for Anesthesiology.

Including Lifestyle Medicine in Medical Education: Rationale for American College of Preventive Medicine/American Medical Association Resolution 959