October 6, 2017: Health Is More Than Healthcare


Karen DeSalvo, MD, MPH, MSc
Former US HSS Acting Assistant Secretary for Health,
National Coordinator for Health Information Technology


Health is More Than Healthcare


Pragmatic clinical trial; Clinical research; Healthcare, Social determinants of health; SDOH; Unmet needs; Health outcomes

Key Points

  • Healthcare costs are concentrated on a “sick few” with a disproportionate number of emergency room visits and hospital stays.
  • Many high-need adults share certain demographics, including being over 65 years old, female, and white, with no high school diploma and lower income.
  • Social determinants of health (SDOH) impact health outcomes through increased non-adherence, readmission, and costs.
  • People with unmet needs (such as food, transportation, and education) have a higher prevalence of diabetes, hypertension, depression, and emergency room usage.
  • “Our zip code affects our health more than our genetic code,” due to inconsistent access to healthcare resources.

Discussion Themes

There have been significant improvements in quality, safety, and patient experience over the past decade, which can be used to create momentum for more positive changes in healthcare.

The University of California at San Francisco’s SIREN project has a goal to develop a clear and coherent research agenda that evaluates social needs priorities reflecting the perspectives of key stakeholder groups.

Agreement on one central SDOH assessment tool among healthcare organizations, rather than each one using its own variation, will allow the sharing of best practices and provide the sharpest view of population needs.

Hurricane Katrina sparked important conversations around social infrastructure and how much social factors truly have an impact on health outcomes.

For More Information

To learn more about social determinants of health (SDOH) and how a strategic research agenda can impact healthcare, follow @KBDeSalvo


@Collaboratory1, @KBDeSalvo, #healthcare#clinicaltrials, #PragmaticTrials, #SDOH, #healthcare, #healthoutcomes, #clinicalresearch, #pctGR