Integrating social and medical care: could it worsen health and increase inequity?
Open accessAbstract
As a result of a large and compelling body of evidence documenting the impacts of social determinants, such as income and education, on health outcomes, health care systems are beginning to incorporate social and economic risk data into health care delivery decisions. But there is a risk that some of these efforts could worsen health and widen health inequities. We highlight 3 examples- including recent policy changes in Medicaid, social needs, informed risk prediction models, and advances in precision medicine-where the inclusion of social risk information threatens to reduce care quality or health care access for some groups of patients. A new dialog is needed about both the opportunities and potential consequences of bringing information about patients' social circumstances into a market-based health care system.
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Ongoing health system efforts to incorporate SDoH into routine care continue to advance.
“ongoing health system efforts to incorporate SDoH into routine care continue to advance [99,100]”
From Machine learning-driven risk prediction for post-hospitalization diabetes case management: Integrating clinical and social determinants of health (2026) · cites this paper as [99]
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Self-citation
- Authors
- Gottlieb, L. M., & Alderwick, H.
- Affiliations
- University of California, San Francisco (US)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2019-01
- Volume
- 17
- Issue
- 1
- Pages
- 77-81
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC6342587
- OpenAlex
- W2912880377
- Cited by
- 40
- References
- 49
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 11 · 2019: 6
- FWCI
- 6.10
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- social determinants of health, health disparities, Medicaid policy, social needs assessment, risk prediction model, precision medicine, health care access, quality of care, market-based health care, education and income
- MeSH terms
- Delivery of Health Care, Health Policy, Humans, Social Work, Delivery of Health Care, Integrated, Health Status Disparities, Social Determinants of Health
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