‘We can’t afford not to do it’: One health system’s early journey into addressing social determinants of health

A few hospitals and health systems have long histories in addressing the social and environmental conditions that affect the health of those living in their communities. The growing awareness of the effect that social needs have on patient outcomes is motivating many more hospitals and health systems to address these issues, but the majority are doing so without access to sustained external funding to support these new efforts. This paper provides an insider’s view into the processes, decisions and realities that influenced one such health system’s early efforts to address social determinants of health. Lessons learned that may be helpful to other hospitals and health systems and their collaborators are highlighted and include the following: recognise the costs of not addressing the social needs of patients; understand that addressing social determinants of health can happen in myriad ways; recognise that it will take some time for science to catch up to the fast pace of innovation in this area; be realistic about the organisation’s capacity; and consider both community need and factors affecting the organisation’s bottom line before choosing a strategy.