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Addressing social factors will improve health care, reduce costs, doctors say


More time, resources needed to assist patients, overcome barriers.

Addressing social factors will improve health care, reduce costs, doctors say

Eight in 10 physicians believe the United States cannot improve health outcomes or reduce health care costs without addressing social factors that affect patient health.

Doctors said they want to address social drivers of health (SDOH) for patients, but 61% said they don’t have time or ability to do so effectively.

The findings were published in the first part of the Physicians Foundation’s 2022 Survey of America’s Physicians. The February 2022 survey of 1,502 doctors examines the current impact of SDOH on physician practice, physician wellbeing, and their patients, as well as possible solutions needed to address the social factors.

"Over the course of the COVID-19 pandemic, there is no question that physicians and patients have all been impacted, some worse than others. Part of what drives the scale of that impact is SDOH," Physicians Foundation CEO Robert Seligson said in a news release. "The desire from physicians to properly address the SDOH is there. We need take the initiative to make changes, like screening patients to identify social needs and creating financial incentives to support physicians in addressing their patients' unique needs."


SDOH, also known as social determinants of health, include:

  • Socioeconomic status
  • Education
  • Neighborhood and physical environment
  • Employment
  • Nutrition and food security
  • Health care access
  • Social support networks

The Physicians Foundation list is similar to that of the federal Centers for Disease Control.

Doctors’ inability to address those “isn't for lack of trying or effort—physicians face many barriers when addressing SDOH,” the Physicians Foundation report said.

Along with limited time, 84% of physicians said they have an insufficient workforce to navigate patients to community SDOH resources.

While some helpful resources exist to navigate the social factors, 77% of physicians reported the community resources were not available, inadequate or difficult to access, and 77% said there is inadequate information on how to access community resources.

More than half the physicians reported SDOH challenges cause them stress on a daily or weekly basis. They cited factors such as existing payer reporting requirements taking time away from discussing patients SDOH (63%) and lack of reimbursement for screening or addressing SDOH (57%).

Future care

Physicians identified multiple policy steps to improve patient health outcomes while ensuring high-quality, cost-efficient care, the survey said.

The top strategies were reimbursing physician-directed efforts to address SDOH (86%), incentivizing payers to invest in availability and quality of community resources to address patients' SDOH (84%) and providing greater flexibility for Medicare Advantage to reimburse for addressing SDOH (81%).

"In 2021, The Physicians Foundation submitted the first-ever SDOH measures to Centers for Medicare and Medicaid Services (CMS), which are currently under consideration to be included in federal payment programs,” Seligson said in the news release. “If adopted, these measures might potentially impact reimbursements for physicians, as well as address SDOH in how our country pays for and delivers care to improve patient health."

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health