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Patient Data: The Authors Reply

  1. New York University School of Medicine New York, New York
PUBLISHED:Free Accesshttps://doi.org/10.1377/hlthaff.2018.0673


We appreciate Eunice Park’s point that data related to social determinants of health should not be solely in the domain of medical providers. We agree that allowing patients to document their own socioeconomic needs can help improve the validity and relevance of the social information collected. Indeed, most screening tools related to the social determinants of health are either meant to be filled out by patients on their own or completed through a facilitated interview with a clinical staff member. Questionnaires may also be supplied to patients before their visits through patient portals. In our article (Apr 2018), we advocated augmenting efforts to capture data on social determinants using community-level administrative data, but we do not believe that this reduces the importance of direct reporting by patients.

Discussions about social determinants of health are excellent opportunities for effective patient engagement at both the individual and community levels.1,2 Out of respect for patient autonomy, initiatives that promote screening for social determinants of health also must provide patients with the option of declining referrals to resources that might help address nonclinical issues. By engaging patients in dialogue about their social needs, however, providers can ensure that their referrals align with patient priorities and are delivered in an accessible manner.


  • 1 Fleming MD, Shim JK, Yen IH, Thompson-Lastad A, Rubin S, Van Natta Met al. Patient engagement at the margins: health care providers’ assessments of engagement and the structural determinants of health in the safety-net. Soc Sci Med. 2017;183:11–8. Crossref, MedlineGoogle Scholar
  • 2 Woolf SH, Zimmerman E, Haley A, Krist AH. Authentic engagement of patients and communities can transform research, practice, and policy. Health Aff (Millwood). 2016;35(4):590–4. Go to the articleGoogle Scholar
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