School of Social Welfare, Mack Center on Public and Nonprofit Management in the Human Services, University of California, Berkeley, California, USA; email:
Division of Primary Care and Population Health, Stanford University, Stanford, California, USA.
Annu Rev Public Health. 2024 May;45(1):443-464. doi: 10.1146/annurev-publhealth-061022-050026. Epub 2024 Apr 3.
In recent years, health care policy makers have focused increasingly on addressing social drivers of health as a strategy for improving health and health equity. Impacts of social, economic, and environmental conditions on health are well established. However, less is known about the implementation and impact of approaches used by health care providers and payers to address social drivers of health in clinical settings. This article reviews current efforts by US health care organizations and public payers such as Medicaid and Medicare to address social drivers of health at the individual and community levels. We summarize the limited available evidence regarding intervention impacts on health care utilization, costs, and integration of care and identify key lessons learned from current implementation efforts.
近年来,医疗保健政策制定者越来越关注解决健康的社会驱动因素,以此作为改善健康和健康公平的策略。社会、经济和环境条件对健康的影响已得到充分证实。然而,人们对医疗保健提供者和支付者在临床环境中解决健康的社会驱动因素所采用的方法的实施和影响知之甚少。本文回顾了美国医疗保健组织和公共支付者(如医疗补助和医疗保险)在个人和社区层面解决健康的社会驱动因素的当前努力。我们总结了关于干预措施对医疗保健利用、成本和护理整合影响的有限可用证据,并确定了从当前实施工作中吸取的主要经验教训。