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Analyzing social determinants of health in theory and practice

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Why health care needs to change to recognize outside factors.

Health care happens outside the walls of hospitals, clinics and physicians’ offices, says William Cooke, MD. As the town physician of Austin, Indiana, Cooke has received national attention and accolades for working there when the opioid epidemic led to a local HIV epidemic. Physicians need to recognize that basic human needs – transportation, housing, a livable wage, and more – all contribute to individual and community health. He described his experiences in his book, “Canary in the Coal Mine: A Forgotten Rural Community, A Hidden Epidemic, and a Lone Doctor Battling for the Life, Health, and Soul of the People.”


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