ACLGIM Leadership Forum

Words of Wisdom

Leading the Charge to Impact Social Determinants of Health

Dr. Volerman ( is an assistant professor of medicine and pediatrics at the University of Chicago.

Social determinants of health (SDOH) directly impact health. Yet, the role of doctors in addressing social needs has traditionally been vague. Each internist is in a position to impact social determinants of health and leaders must support and elevate these efforts.

The Society of General Internal Medicine recently released a position statement on the internists’ role in social determinants of health (SDOH).1 This statement outlines actions that internists can take across their spheres of influence:

  • Clinicians: Apply relationship-centered communication and self-reflection about biases. Develop and work in interprofessional care teams to provide whole-person care.
  • Health system leaders: Encourage partnerships between health systems and community members/community-based organizations. Leverage economic and political power to invest in local community. Prioritize workplace diversity and family-friendly workplace policies.
  • Educators: Include social and relationship competency for physicians. Adopt holistic admissions. Develop and implement curricula for SDOH at every stage of education. Make relevant outcomes part of accreditation processes.
  • Researchers: Use science as a tool of inclusion through methodology and outcomes. Encourage authentic community partnerships at all levels of research. Partner with researchers outside of medicine to identify innovative and interdisciplinary solutions.
  • Advocates: Advocate for assessment of the health impact with key policies. Advocate for alignment of community health needs assessments with communities served. Advocate for governments to optimize financial structures that share money from payer savings programs in health care with other public sectors.

No matter an internist’s specific day-to-day role, opportunities exist for each individual to positively impact SDOH and help work toward a more just world, which is especially critical as our world grapples with the impact of centuries of structural racism clearly visible in the ongoing pandemic and police brutality. In order to do so, it is imperative that leaders in academic general internal medicine support clinicians, educators, researchers, and advocates in addressing SDOH—in both words and in action. One can simply start by sharing this statement with their colleagues, clinic teams, research lab members, and health system administration. Such a statement offers opportunities for individuals and groups (e.g., divisions, clinics) to reflect on their prior actions and inactions as well as consider areas of personal and collective action today and in the future.

Leaders can commit to bringing SDOH into their day-to-day discussions and meetings, using it as an opportunity to think about how each group they lead or serve on—be it division, clinic, committee, etc.—can affect social needs in their existing work and future plans. Recognizing the effect of social needs and making it part of the conversation is an important first step to action. Building upon those individual steps, leaders can support institutional, local, and national change that is critical to impact social needs at an individual and a population level. For example, clinical leaders can advocate for adequate staffing of social workers and community health workers to work in collaboration with physicians to address social needs in outpatient and inpatient settings. Research leaders can intentionally include community-engaged research as a priority for funding mechanisms and grant reviews. Educational leaders can refine admissions processes to look beyond test scores as well as develop and implement SDOH curricula in classroom and clinical settings. All leaders can support diversity in admission and hiring as well as advocate for policies and funding that support health at all levels. Importantly, local efforts and changes can be shared and disseminated broadly.

Intentional work by each internist and leader in our spheres of influences is instrumental to move the needle forward. Together, we can understand and address the social drivers of health and influence change for our patients, communities, and nation


  1. Byhoff E, Kangovi S, Berkowitz SA, et al. A Society of General Internal Medicine position statement on the internists’ role in social determinants of health [published online ahead of print, 2020 Jun 9]. J Gen Intern Med. 2020;10.1007/s11606-020-05934-8. doi:10.1007/s11606-020-05934-8.


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