By Dennis Archambault
The recent report by the National Academies of Sciences, Engineering, and Medicine, “Communities in Action: Pathways to Health Equity,” offers promise in efforts to promote health equity. Authority Health has long held that one of those pathways is through the primary care relationship between physician or provider and patient. Medical residents in our teaching health center program are oriented to population health through a University of Michigan certification program, with the expectation that they will incorporate this knowledge into their primary care practice.
The Canadian Medical Association has been a progressive voice in this area. Four years ago, it adopted a policy statement that has direct implications for practitioners: “Health equity is created when individuals have the opportunity to achieve their full health potential. Health equity is undermined when social and economic conditions, the social determinants of health, prevent or constrain people from taking actions or making decisions that would promote health. While the majority of these determinants fall outside of the traditional health sector, the implications for health services in Canada are enormous. Most major diseases including heart disease and mental illness follow a social gradient with those in lowest socio-economic groups having the greatest burden of illness.”
In a 2008 report, the World Health Organization has challenged all providers: “Those in the health sector bear witness to, and must deal with, the effect ts of the social determinants of health on people… The health care system and those working within it have an important and often under-utilized role in reducing health inequalities through action on the social determinants of health.
Finally, recently Cecil Wilson, M.D., president of the World Medical Association, said in a blog post, “The primary responsibility for addressing the social determinants of health is that of government and society. But physicians, by virtue of their role in the health care system – taking care of patients and possessing an intimate understanding of health care – must play a role in addressing this problem.”
We hope that social determinants become included in standard health histories, and ongoing counseling with routine wellness visits. That, coupled with navigation assistance can help physicians direct their patients to resources that will mitigate the social barriers to achieving optimum health.

Dennis Archambault is vice president, Public Affairs, for Authority Health.