Social Determinants of Health: The Promise, Opportunity, and Challenges

Abstract

Social determinants of health (SDoH) — nonclinical factors such as housing instability, food insecurity, employment status, and education — account for approximately 80% of health outcomes, influencing conditions ranging from acute illness to chronic disease. Despite their importance, most healthcare organizations lack formal governance structures to oversee the collection, integration, and use of SDoH data. In response to new accreditation requirements from The Joint Commission mandating SDoH screening and follow-up, this study explores strategies for integrating SDoH into clinical workflows to advance equity and holistic care. Using a qualitative descriptive design, we conducted semi-structured interviews with 4 healthcare stakeholders, including clinicians, administrators, and data specialists, recruited through purposive sampling. Interviews were conducted via secure virtual platforms, recorded, and transcribed verbatim. Data were coded inductively and thematically analyzed to identify common patterns and actionable insights. Findings highlight the need for screening tools that align with clinical workflows and staff responsibilities, supported by leadership engagement and clear implementation protocols. Standardized documentation practices, including structured coding systems, are essential for interoperability and data utility but require training, institutional alignment, and incentivization. Participants also emphasized the growing importance of patient-driven data collection, which empowers patients to actively contribute to SDoH screening and ensures data relevance and usability. Ultimately, the meaningful integration of SDoH data depends on blending technological solutions with human-centered approaches to improve care outcomes and promote health equity.