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It might seem reasonable to assume—particularly for health care professionals—that health care is among the most important factors in determining a person's or a population's health.

Addressing Social Determinants of Health

It isn't.

Although health care plays an important role, it's actually a relatively weak health determinant, according to studies1,2 cited by the Henry J. Kaiser Family Foundation (KFF). According to a KFF issue brief, research suggests that health behaviors such as smoking, diet, and exercise are the most important determinants of premature death. Furthermore, health behaviors are only one element of a much bigger picture.3

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  1. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270(18):2207–2212. doi:10.1001/jama.1993.03510180077038. https://jamanetwork.com/journals/jama/article-abstract/409171. Accessed May 3, 2019.
  2. Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238-1245, doi:10.1001/jama.291.10.1238. https://jamanetwork.com/journals/jama/article-abstract/198357. Accessed May 3, 2019.
  3. Artiga S, Hinton E. Beyond health care: the role of social determinants in promoting health and health equity. Issue Brief. May 2018. Henry J Kaiser Family Foundation. https://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/. Accessed May 3, 2018.
  4. Understanding Social Determinants of Health. Healthy People 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health/objectives. Accessed May 3, 2019.
  5. Secretary's Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020. Healthy People 2020: An Opportunity to Address the Societal Determinants of Health in the United States. July 26, 2010. https://www.healthypeople.gov/sites/default/files/SocietalDeterminantsHealth.pdf. Accessed May 3, 2019.
  6. Neeru G, Castillo-Laborde C, Landry MD. Health-related rehabilitation services: assessing the global supply of and need for human resources. BMC Health Serv Res. 2011;11:276.
  7. Hornbuckle LM, Amutah-Onukagha N, Bryan A, et al. Health disparities in women. Clin Med Insights: Women's Health. 2017;10:1-4.
  8. Wu JM, Hundley AF, Fulton RG, et al. Forecasting the prevalence of pelvic floor disorders in US women: 2010 to 2050. Obstet Gynecol. 2009;14(6):1278-1283.
  9. Magnusson DM, Minkovitz CS, Kuhlthau KA, et al. Beliefs regarding development and early intervention among low-income African American and Hispanic mothers. Pediatrics. 2017;140(5):e20172059.
  10. Marquez PV. Healthy Women Are the Cornerstone of Healthy Societies. The World Bank. January 12, 2017. https://blogs.worldbank.org/health/healthy-women-are-cornerstone-healthy-societies. Accessed April 16, 2019.
  11. National health and medical organizations issue declaration, urge bold action to fight climate change declaration on climate change and health [news release]. American Public Health Association; April 4, 2016. https://www.apha.org/news-and-media/news-releases/apha-news-releases/2016/declaration-on-climate-change-and-health.
  12. Centers for Disease Control and Prevention. Disability and Health: Cigarette Smoking Among Adults with Disabilities. https://www.cdc.gov/ncbddd/disabilityandhealth/smoking-in-adults.html. Accessed May 3, 2019.
  13. Jensen GM, Nordstrom T, Mostrom E, et al. National study of excellence and innovation in physical therapist education, part 1—design, method, and results. Phys Ther. 2017;97:857–874.
  14. Jensen GM, Nordstrom T, Mostrom E, et al. National study of excellence and innovation in physical therapist education, part 2—a call to reform. Phys Ther. 2017;97:875–888.

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