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Integrating Rehabilitation and Social Care: Opportunities for Advancing Research, Training, Practice, and Policy

      The World Health Organization (WHO) describes “the conditions in which people are born, grow, live, work and age” as social determinants of health (SDOH).

      Office of Disease Prevention and Health Promotion. Social determinants of health. Available at: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health. Accessed October 25, 2021.

      Population or community level SDOH manifest at the individual level as social needs.
      • Auerbach J
      • Castrucci B.
      Meeting individual social needs falls short of addressing social determinants of health.
      As the quality of SDOH declines and unmet social needs increase, worse health outcomes are observed, accounting for one-third of total deaths in the US annually.
      • Artiga S
      • Hinton E.
      Beyond health care: the role of social determinants in promoting health and health equity.
      • Davidson KW
      • Krist AH
      • Tseng C
      • et al.
      Incorporation of social risk in US preventive services task force recommendations and identification of key challenges for primary care.
      • Wilkinson RG
      • Marmot M
      WHO Healthy Cities Project, World Health Organization. Social determinants of health: the solid facts.
      Globally, the SDOH are recognized to be responsible for 70%-90% of a person's health and are even more influential in health outcomes for vulnerable populations, such as persons with activity limitations and participation restrictions.

      Huffstetler E, Quincy L. Addressing the unmet medical and social needs of complex patients. Available at:https://www.healthcarevaluehub.org/advocate-resources/publications/addressing-unmet-medical-and-social-needs-complex-patients. Accessed October 25, 2021.

      Magnan S. Social determinants of health 101 for health care: five plus five. Washington (DC): National Academy of Medicine; 2017.

      • Hotter B
      • Padberg I
      • Liebenau A
      • et al.
      Identifying unmet needs in long-term stroke care using in-depth assessment and the post-stroke checklist - the managing aftercare for stroke (MAS-I) study.
      • Shahsavari H
      • et al.
      Upper limb amputation; care needs for reintegration to life: an integrative review.
      • Zeiler KJ
      • Zeiler FA.
      Social determinants of traumatic brain injury in the North American Indigenous population: a review.
      • Rethorn ZD
      • Cook C
      • Reneker JC.
      Social determinants of health: if you aren't measuring them, you aren't seeing the big picture.
      • Frier A
      • Barnett F
      • Devine S
      • Barker R.
      Understanding disability and the 'social determinants of health': how does disability affect peoples' social determinants of health?.
      Unmet social needs are exacerbated by illness, injury, the acquisition of a disability or a decline in physical functioning that may change one's employment, income, housing, and transportations statuses.
      • Frier A
      • Barnett F
      • Devine S
      • Barker R.
      Understanding disability and the 'social determinants of health': how does disability affect peoples' social determinants of health?.
      Studies estimate that 46%-78% of people with disability, major complex chronic conditions, or frailty have unmet social needs including financial barriers (affording food or housing) and lack of transportation.

      Huffstetler E, Quincy L. Addressing the unmet medical and social needs of complex patients. Available at:https://www.healthcarevaluehub.org/advocate-resources/publications/addressing-unmet-medical-and-social-needs-complex-patients. Accessed October 25, 2021.

      ,
      • Zeiler KJ
      • Zeiler FA.
      Social determinants of traumatic brain injury in the North American Indigenous population: a review.
      ,

      Shah NR, Rogers AJ, Kanter MH. Health care that targets unmet social needs. NEJM Catal Innov Care Deliv 2016;2.

      Global attention to SDOH has led to recommendations for health care systems to more deliberately be involved in addressing patients’ needs.
      National Academies of Sciences, Engineering, and Medicine
      Integrating social care into the delivery of health care: moving upstream to improve the nation's health.
      It is critical that rehabilitation services align with national recommendations.

      Keywords

      List of abbreviations:

      NASEM (National Academies of Sciences, Engineering, and Medicine), SDOH (social determinants of health), WHO (World Health Organization)
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