title: Leveraging the Social Determinants of Health: What Works?
abstract: We summarized the recently published, peer-reviewed literature that examined the impact of investments in social services or investments in integrated models of health care and social services on health outcomes and health care spending. Of 39 articles that met criteria for inclusion in the review, 32 (82%) reported some significant positive effects on either health outcomes (N = 20), health care costs (N = 5), or both (N = 7). Of the remaining 7 (18%) studies, 3 had non-significant results, 2 had mixed results, and 2 had negative results in which the interventions were associated with poorer health outcomes. Our analysis of the literature indicates that several interventions in the areas of housing, income support, nutrition support, and care coordination and community outreach have had positive impact in terms of health improvements or health care spending reductions. These interventions may be of interest to health care policymakers and practitioners seeking to leverage social services to improve health or reduce costs. Further testing of models that achieve better outcomes at less cost is needed.
authors.affiliation: Department of Health Policy and Management, Harvard Business School, Boston, Massachusetts, United States of America.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Taylor
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Annabel Xulin
authors.initials: AX
authors.lastname: Tan
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Caitlin E
authors.initials: CE
authors.lastname: Coyle
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Chima
authors.initials: C
authors.lastname: Ndumele
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Erika
authors.initials: E
authors.lastname: Rogan
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Maureen
authors.initials: M
authors.lastname: Canavan
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Curry
authors.affiliation: Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, United States of America.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Bradley
mesh_terms: D003159:Community-Institutional Relations; D017048:Health Care Costs; D006291:Health Policy; D006798:Housing; D006801:Humans; D007182:Income; D018673:Nutrition Policy; D017063:Outcome Assessment, Health Care; D064890:Social Determinants of Health / Q000191:economics; D012947:Social Work