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      Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health

      1 , 1 , 1 , 2 , 1
      Annual Review of Public Health
      Annual Reviews

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          Abstract

          There has been an explosion of interest in addressing social needs in health care settings. Some efforts, such as screening patients for social needs and connecting them to needed social services, are already in widespread practice. These and other major investments from the health care sector hint at the potential for new multisector collaborations to address social determinants of health and individual social needs. This article discusses the rapidly growing body of research describing the links between social needs and health and the impact of social needs interventions on health improvement, utilization, and costs. We also identify gaps in the knowledge base and implementation challenges to be overcome. We conclude that complementary partnerships among the health care, public health, and social services sectors can build on current momentum to strengthen social safety net policies, modernize social services, and reshape resource allocation to address social determinants of health.

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          The Social Determinants of Health: It's Time to Consider the Causes of the Causes

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            Social Conditions As Fundamental Causes of Disease

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              U.S. disparities in health: descriptions, causes, and mechanisms.

              Eliminating health disparities is a fundamental, though not always explicit, goal of public health research and practice. There is a burgeoning literature in this area, but a number of unresolved issues remain. These include the definition of what constitutes a disparity, the relationship of different bases of disadvantage, the ability to attribute cause from association, and the establishment of the mechanisms by which social disadvantage affects biological processes that get into the body, resulting in disease. We examine current definitions and empirical research on health disparities, particularly disparities associated with race/ethnicity and socioeconomic status, and discuss data structures and analytic strategies that allow causal inference about the health impacts of these and associated factors. We show that although health is consistently worse for individuals with few resources and for blacks as compared with whites, the extent of health disparities varies by outcome, time, and geographic location within the United States. Empirical work also demonstrates the importance of a joint consideration of race/ethnicity and social class. Finally, we discuss potential pathways, including exposure to chronic stress and resulting psychosocial and physiological responses to stress, that serve as mechanisms by which social disadvantage results in health disparities.
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                Author and article information

                Journal
                Annual Review of Public Health
                Annu. Rev. Public Health
                Annual Reviews
                0163-7525
                1545-2093
                April 01 2021
                April 01 2021
                : 42
                : 1
                : 329-344
                Affiliations
                [1 ]The Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA;, , ,
                [2 ]School of Medicine, Washington University in St. Louis, St. Louis, Missouri 63110, USA
                Article
                10.1146/annurev-publhealth-090419-102204
                33326298
                779bf5f7-e0e7-439b-aa79-a920d46f49f7
                © 2021

                http://creativecommons.org/licenses/by/4.0/

                History

                General life sciences,Immunology,Social & Behavioral Sciences,Health & Social care,Infectious disease & Microbiology,Public health

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