Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

Recently there has been increased recognition of the importance of these factors to health. Moreover, the Affordable Care Act (ACA) includes provisions to help bridge health care and community health. It provides for enhanced focus on prevention and primary care, including the creation of the National Prevention Council and a National Prevention Strategy; support for testing and spreading of new delivery and payment arrangements; initiatives to foster increased workforce diversity, and a new requirement for not-for-profit hospitals to conduct community health needs assessments. Reflecting the increased focus and new opportunities provided under the ACA, a growing number of initiatives are emerging at the national, state, and local level to address broader determinants of health. Given Medicaid’s longstanding role serving a diverse population with complex health, behavioral, and social needs, efforts to address social determinants of health are emerging through many Medicaid delivery and payment initiatives. This brief provides an overview of the broad factors that influence health and describes emerging efforts to address them, including initiatives within Medicaid.