Adult patients with diabetes (n = 3745) seen at Johns Hopkins Medicine primary care sites were referred to the Wilmer Eye Institute either based on a primary care provider referral or autonomous AI diagnostic result (referral was made after a positive or non-diagnostic result). An inverse-probability-weighted regression, which incorporated propensity score matching on social determinants of health and relevant clinical variables, showed that implementation of an autonomous AI-assisted diabetic screening program in a primary care clinic was associated with increased presentation to eye care specialist care by African-Americans (p = 0.02). This is significant because African-Americans have traditionally been less likely to undergo annual screening exams and more likely to present with more severe forms of diabetic retinopathy (DR). The results suggest a potential association between office-based, AI-assisted DR screening and improved downstream ophthalmic access for African-American patients. However, given that the analysis was exploratory, this association should be interpreted cautiously and further validated.

Social determinants of health (SDOH), the nonmedical factors influencing patients across individual and systematic levels, are essential to comprehensive healthcare. However, there is varied guidance in exactly how it should be taught or assessed in physician assistant (PA) programs, as well as what methodologies are effective or preferred by students. A between-and-within groups study was designed for first-year PA students to evaluate their opinions, confidence levels, and comfort regarding SDOH delivered by 2 brief educational modules (one using an expert panel and the other a gamified approach). A total of 48 students participated in the study. Results found that students appreciated the importance of SDOH to patient care and valued the application of clinical and public health resources. Students' confidence and comfort levels regarding SDOH improved following each educational module (P < .05 pre vs. post comparisons). Students valued modular approaches to learning SDOH and equally prefer the panel and game formats. Students ranked direct clinical care as their highest preference in how they would prefer SDOH principles to be taught, followed by case-based learning, panel-based, and gamified-based approaches. Online learning was the least preferred teaching method. These results suggest (1) modular approaches may be an effective means to teach SDOH, (2) SDOH could be taught longitudinally across the curriculum to reinforce understanding, and (3) delivery of SDOH curricula in PA education could consider nontraditional formats that promote interactive learning.

Individual effect of posttraumatic stress disorder (PTSD) and social determinants of health (SDoH) on healthcare utilization and well-being among cancer patients remains unclear. We sought to assess independent and combined effects of these factors on healthcare utilization and self-reported well-being. All of Us Research Program was used to identify participants with cancer and/or PTSD, as well as individuals with neither. SDoH burden, healthcare utilization, and well-being were assessed relative to PTSD on multivariable logistic regression adjusting for sociodemographic factors. Among 16,261 participants, 11.6% (n = 1895) had cancer, 1.4% (n = 228) had cancer and PTSD, and 20.1% (n = 3281) had PTSD alone. PTSD was associated with higher odds of emergency room visits (aOR 4.16, 95% CI 3.80-4.55), poor mental (aOR 3.77, 95% CI 3.43-4.14), and emotional health (aOR 3.76, 95% CI 3.41-4.16) (all p < 0.001). High SDoH burden independently predicted increased inpatient and emergency visits (aOR 1.24, 95% CI 1.13-1.36), as well as greater risk of poor quality of life (aOR 3.71, 95% CI 3.20-4.32) (all p < 0.001). Cancer patients with PTSD and high SDoH burden had substantially greater odds of poor mental health (aOR 10.92, 95% CI 9.33-12.77) and poor emotional health (aOR 12.20, 95% CI 10.33-14.41) (all p < 0.001). Cancer, PTSD, and high SDoH burden were independently associated with greater healthcare use and worse well-being with combined exposures amplifying risk among cancer survivors. Survivors with PTSD and high SDoH burden are especially vulnerable. Integrating trauma-informed care and SDoH screening strengthens survivorship equity and outcome.

Migrants arriving in the United Kingdom (UK), many of whom experience vulnerability before and during migration, face a double burden of communicable and non-communicable diseases shaped by cumulative exposures in their countries of origin, across the migration journey, and compounded by fragmented access to care upon arrival. Despite improvements in pre-entry health assessments, post-arrival provision in reception centres remains inconsistent, with significant gaps in infectious disease screening, mental health support, medication continuity, and timely registration with a general practitioner (GP). Community-led initiatives like Doctors of the World's Safe Surgeries and the Oxford Refugee Health Initiative promote inclusive healthcare access, yet remain limited in scale. Using a social determinants of health (SDH) lens, this perspective highlights how structural barriers-including overcrowded accommodation, language challenges, and unclear entitlements-undermine the effectiveness of existing health policies and widen inequalities. We propose an essential care package for UK migrant reception centres that integrates early screening, stable access to medicines, mental health assessment, environmental health measures, and robust continuity of care for non-communicable diseases through clear referral pathways into the National Health Service (NHS). Embedding this approach within current public health infrastructure would reduce preventable morbidity, strengthen health system efficiency, and advance the UK's commitment to Sustainable Development Goals. Strengthening care at the point of arrival is therefore critical to promoting health equity and ensuring that no one is left behind.

Primary care home visits benefit older adults and adults with disabilities but are often challenging to sustain. While telehealth is less costly and time-intensive, potential limitations include access, assessment adequacy, and patient satisfaction. To improve patient access to effective telehealth encounters as a component of home-based care while educating medical students via home visits. Home-based primary care program partnership between a federally qualified health center and a tertiary academic center in the Southeast US from November 2022 to June 2023. Eight medical students and eight patients. Student pairs facilitated video telehealth encounters with patients in their homes supervised by an off-site clinician. Outcome measures included clinical activities conducted, patient satisfaction, and medical student reflections. Students facilitated 28 enhanced telehealth visits. In total, 287 clinical activities were performed. Of the 238 activities evaluated for clinical utility, 13.2% warranted an intervention. All patient participants were satisfied and interested in continuing. Student reflection themes included valuing longitudinal relationships, home-based care, and social determinants of health. This novel program may improve patient access to home-based care via telehealth encounters facilitated by medical students and, concurrently, provide a model for student participation in home visits.

This review article provides a summary of findings on the social determinants of chronic disease prevalence, incidence, and mortality from the Atherosclerosis Risk in Communities (ARIC) Study, community surveillance of coronary heart disease conducted in four geographically distinct United States communities from 1987 through 2014 and an ongoing longitudinal cohort of 15,792 men and women recruited from those communities. The ARIC community surveillance documented the contribution of poor neighborhood socioeconomic status to trends in heart disease and to disparities in associated medical care. Data from members of the ARIC Study cohort, provide evidence on the importance of neighborhood and individual-level social determinants to the prevalence of cardiovascular risk factors and to the burden of cardiovascular disease and mortality, dementia, and kidney disease. Findings from the unique ARIC Lifecourse Socioeconomic Study conducted within the ARIC cohort, underscore the importance of socioeconomic exposures across the lifecourse to the prevention of chronic disease. The rich ARIC data on neighborhood deprivation, environmental exposures, physical and built environments, and racial and economic segregation, provide a foundation for innovative methodological approaches that integrate demographic, socioeconomic, behavioral, and clinical risk factors-enabling researchers to identify optimal targets for effective chronic disease prevention.

Predictive value of individual social risk versus neighborhood-level social vulnerability for trauma outcomes.

Frailty is a geriatric syndrome of increased physiological vulnerability, decreasing an older adult's ability to successfully cope with health stressors. Social determinants of health (SDOH), including rural residence, can amplify healthcare disparities for older adults due to less accessibility to resources and lead to worse health outcomes. While the impact of rurality on older adult health is well-established, little is known about how the interaction of SDOH and geographical residence impact frailty status in older adults. Older adults (65+ years) in the National Health and Aging Trend Study (2011-2021) were categorized using Fried's frailty phenotype (robust, pre-frail, frail). Rurality was defined using the 2013 Rural-Urban Continuum Codes. Generalized estimation equations with generalized logit link function determined the relationship between SDOH (healthcare access, community support, income, education) and frailty status. Of n = 6082 participants (56.4% female), the mean age was 75.12 years (SE 0.10), 1133 (18.6%) lived in rural residence, and 2652 (53.0%) had pre-frailty. Although there was no relationship between geographical residence and frailty status (p = 0.73), we did observe lower associated odds of worse frailty status for those with Medigap insurance coverage (0.81, SE 0.08; p = 0.04) and inconsistent frailty status trends for those of divorced (1.12, SE 0.05; p = 0.007) and never married (0.20, SE 0.03; p < 0.001) status in urban areas. Our findings suggest that geographic residence may modify the relationship between SDOH and frailty status in older adults, providing novel insight into the complexity of these interactions. This work is important for identifying modifiable areas where additional support interventions may be important for mitigating frailty development and progression for older adults with efforts at both the individual and system levels.

The Intersection of Social Determinants of Health and Informatics: A Review of Strategies to Improve Care Delivery.

The Cost of PRP: Disparities in orthobiologic utilization.

Medicalizing the social determinants of health and the inadvertent reproduction of inequities through social-care program implementation in the United States.

Incorporating polygenic risk scores and social determinants of health across populations: Considerations and best practices in research

Beyond access: Digital skills as a new social determinant of health among older adults - evidence from a longitudinal panel study.

Care and support needs of families in the first 9 months after PICU discharge: A multi-center, longitudinal, qualitative study.

Social determinants of health associated with receipt of psychotherapy for veterans with posttraumatic stress disorder.

Associations Between Area Deprivation Index and the Time to Presentation of Scaphoid Fractures.

Structural violence, population health, and health equity.

Neighborhood socioeconomic disadvantage and antenatal depressive symptoms.

Accountability as Self-Determination: Abolitionist conceptions of health, wellbeing, and safety.

Cardiovascular disease (CVD) remains one of the leading causes of mortality in England, with its burden disproportionately concentrated in the North. Studies in the last few decades have highlighted that factors such as low education, high levels of unemployment, poor housing and reduced access to healthy food are strongly associated with the higher incidence of lifestyle risks-smoking, obesity and physical inactivity. These in turn increase rates of hypertension, dyslipidaemia and diabetes in the population. Beyond lifestyle factors, psychosocial mechanisms such as chronic stress and associated increase in allostatic load, due to long-standing deprivation, contribute to the biological risk of CVD. Early life disadvantage, ethnic and gender inequalities, and delayed management of intermediate risk factors further exacerbate the regional divide in England. Furthermore, the long-term impacts of COVID-19 and healthcare-associated national policies, including austerity-related funding deductions, have intensified pre-existing disparities. Evidence demonstrates that current preventative strategies, such as the National Health Service Health Check, have had limited success in reaching underserved communities, highlighting the need for targeted therapies. The National Institute of Health and Care Research Inequalities Challenge is a remarkable opportunity for the United Kingdom's (UK) leading research organisations to help tackle these inequalities associated with CVD and make a significant difference. Without such efforts, the excess CVD burden is likely to persist, perpetuating entrenched health inequalities. This review examines the different social determinants of health underlying these disparities, with a particular focus on socioeconomic deprivation, lifestyle risk factors, environmental and structural issues.