Artificial intelligence, ChatGPT, and other large language models for social determinants of health: Current state and future directions
Open accessAbstract
This perspective highlights the importance of addressing social determinants of health (SDOH) in patient health outcomes and health inequity, a global problem exacerbated by the COVID-19 pandemic. We provide a broad discussion on current developments in digital health and artificial intelligence (AI), including large language models (LLMs), as transformative tools in addressing SDOH factors, offering new capabilities for disease surveillance and patient care. Simultaneously, we bring attention to challenges, such as data standardization, infrastructure limitations, digital literacy, and algorithmic bias, that could hinder equitable access to AI benefits. For LLMs, we highlight potential unique challenges and risks including environmental impact, unfair labor practices, inadvertent disinformation or "hallucinations," proliferation of bias, and infringement of copyrights. We propose the need for a multitiered approach to digital inclusion as an SDOH and the development of ethical and responsible AI practice frameworks globally and provide suggestions on bridging the gap from development to implementation of equitable AI technologies.
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Recent studies have utilized large language models (LLMs) for the identification of SDoH factors.
“Recent studies have utilized the use of large language models (LLMs) for the identification of SDoH factors19,24,45,46.”
From Social determinants of health extraction from clinical notes across institutions using large language models (2025) · cites this paper as [19]
Many studies, even recent ones, have focused on a limited set of SDoH factors (up to 8 factors).
“Firstly, many studies, even the recent ones19–25 have focused on a limited set of SDoH factors (up to 8 factors).”
From Social determinants of health extraction from clinical notes across institutions using large language models (2025) · cites this paper as [19]
The SDOH section describes gaps in research on complex determinants, and the ‘Research on SDOH and health outcomes’ section names determinants emphasized in several reviews. Neither says that many studies, including recent ones, examined no more than eight SDoH factors. Searches for a limited number of factors and the eight-factor threshold found no passage establishing that claim. (LLM, conf=0.70)
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Moyenuddin, M., & File, T. M. (2026) · Infectious Diseases in Clinical Practice · doi:10.1097/ipc.0000000000001621
- Authors
- Ong, J. C. L., Seng, B. J. J., Law, J. Z. F., Low, L. L., Kwa, A. L. H., Giacomini, K. M., & Ting, D. S. W.
- Affiliations
- SingHealth (SG)
- National University of Singapore (SG)
- University of California, San Francisco (US)
- Corresponding author
- Ting, Daniel Shu Wei
- ORCID
- Venue
- Cell Reports Medicine
- Publisher
- Elsevier BV
- Published
- 2024-01
- Volume
- 5
- Issue
- 1
- Pages
- 101356
- ISSN
- 2666-3791 (ISSN-L)
- PMC
- PMC10829781
- OpenAlex
- W4390921272
- Cited by
- 111
- References
- 94
- Citations by year
- 2026: 32 · 2025: 51 · 2024: 28
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cell Reports Medicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Agency for Science, Technology and Research (A20H4g2141, H20C6a0032, MOH-CIAINV21nov-001)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Social Sciences › Safety Research › Ethics and Social Impacts of AI
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Keywords
- social determinants of health, large language models, ChatGPT, artificial intelligence in healthcare, health disparities, digital health, disease surveillance, algorithmic bias, digital literacy, digital inclusion, environmental impact of AI, AI hallucination, copyright infringement, AI ethics framework, COVID-19 pandemic
- MeSH terms
- COVID-19, Artificial Intelligence, Humans, Language, Pandemics, Social Determinants of Health
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