4 Social Determinants of Health You Have to Address in Advanced Primary Care

Traditionally, healthcare organizations and providers have focused the lens of primary care on a patient’s physical and clinical needs and care. Topics such as their mental wellbeing, lifestyle, and social determinants of health weren’t factored in.  

However, approaches are changing. As many seek advanced primary care solutions that encompass a member’s behavioral health and lifestyle, it’s important to make sure that key social determinants of health are addressed as well. Leaving social determinants unattended can undermine even high-quality clinical care and prevent members from achieving the level of health and wellness that they otherwise could.

Why Take Social Determinants of Health into Consideration?

Social determinants of health are the conditions in which members live, work and play. These are matters like access to fresh food, reliable transportation, safe housing, childcare, and more. They have a foundational role in a member’s health and wellness. If this foundation is cracked, it needs to be repaired. Addressing social determinants of health is critical to effective advanced primary care. For instance, a member who attends a routine screening may find they have high blood pressure. Their provider recommends a course of treatment including diet and exercise. Living in a food desert with little to no access to fresh foods, being unable to afford a gym membership, or living in a location that makes running outside challenging can all compromise the member’s ability to follow their treatment plan and effectively manage their blood pressure. 

Taking social determinants into account is a key element of a whole-person care approach, such as advanced primary care. As such, these factors must be addressed for an advanced primary care solution to truly be advanced.

The Role Organizations Have in Supporting Social Determinants of Health in Their Population

Social determinants are sometimes seen as someone’s personal business, and therefore their personal problem. But they are systemic problems that directly impact health. They are hard-to-solve issues that individuals may not be able to change on their own. Large organizations can lend their weight to helping their employees solve these systemic issues at the individual level. Organizational support and community resources can have a considerable effect on the overall health and wellbeing of your population. 

In addition, addressing social determinants can reinforce organizational diversity and inclusion initiatives. Healthcare solutions aimed at providing health equity put weight behind the words, “You belong here.” Social determinants of health are also a core element of culturally competent care, which uses a health equity approach to solve systemic challenges your population is facing. It gives your population the feeling of individualized healthcare designed with intention for them, meeting their needs and makes them feel seen, welcomed, and included. It helps them be the best versions of themselves at home and at work, keeping them engaged and staving off burnout.

Four Social Determinants of Health to Address First

There are many social determinants that influence an individual’s health and wellness, and each of them interact with each other. While every population is different, we’ve seen four social determinants that are a good place to start. 

Food Insecurity 

Food insecurity encompasses issues of access and cost to food. Members may live in a food desert where finding fresh, healthy food is all but impossible. Or they may have medical need for a certain diet they struggle to afford. Rural or third-shift workers may struggle to get to grocery stores while they are open. Whatever the cause, helping your population connect with community or organizational resources that help them have reliable and affordable groceries enables your members to have a healthy diet in support of good health. 


Lack of available private or public transportation can limit where and when they shop for groceries and household goods or go see their doctor. It impacts the hours they can work, limiting their income and reducing their productivity. Building organizational initiatives and awareness of community programs to supply transportation needs can help your members be able to do what they need to do.

Physical Activity 

Being physically active seems simple. You join a gym or get some equipment at home and join a digital fitness platform. For that matter, you can just go outside and walk, right? The truth is not always so simple. Members who live in unsafe or unwalkable neighborhoods and don’t have the ability to join a gym or purchase equipment for the home are left with few options at their disposal. Adding a fitness center or walking path to your workplace or connecting your members with pathways to physical activity can help them manage their weight and get moving. 

Financial Insecurity 

Providing help finding financial security can alleviate other social determinants by providing greater capacity for someone to secure reliable transportation, stable housing, healthy food, and access to appropriate levels of physical activity. On its own, financial insecurity can cause intense stress, anxiety, and uncertainty in someone’s life. Community programs or organizational initiatives can help manage debt, budget income, or have access to fair and honest banking and lending resources.

Support Your Population with Knowledge and Action 

So how do you know which social determinant to start with? What other determinants may be present in your population? Answering these questions and others like them are important, so getting to know your population is important. Trust between your members and the ones asking the questions, be it your own human resources team or a provider from a healthcare partner, is critical. Make sure members have a place where they feel safe enough to be honest about the challenges they are facing at home and at work. Building this trust can take time. Be patient and eventually you’ll learn how best to help your members.  

Once you’ve learned your population’s needs there’s no time to waste. Get to work finding out what your organization can do to support members and identify and connect them to community resources.

The environment where someone lives, works, and plays impacts their lives immensely. It plays an enormous role in their health. An effective advanced primary care solution should not only consider social determinants but should also address them. Premise sees social determinants of health as so central to healthcare that it is built into our care model and incorporated at the point of care. Our integration with Find Help, a national network that connects individuals seeking help to verified social care services, empowers our providers to connect members with community resources in food security, financial security, transportation, and more, while members can use a self-service portal to access these resources on their own time.  

Contact us to learn more about an advanced primary care solution that can help you support your population. 

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