Table 4.

Implications for Action Based on Themes Discussed at the 2017 Starfield Summit

ThemeImplications for Action
EducationIncorporate advocacy, community organizing, and relational leadership skills into medical education to enable future health professionals to partner with communities to create social change.
Change admission policies for health professional institutions to prioritize recruiting individuals from underrepresented populations and communities of need.
Improve didactic exposure to vulnerable groups in health professional education and provide in-person experiences with these populations.
Clinical practiceUse validated screening tools to identify SDHs and social needs.
Create data-enabled teams and workflows to identify and address SDHs in the context of the clinical setting.
Develop roles in team-based primary care that include creating meaningful partnerships with community members and organizations (eg, community health workers, community organizers).
Examine each clinical encounter from the perspective of systemic injustice or structural violence.
ResearchPartner with clinicians to develop and validate SDH screening tools; partner with educators to develop and measure effectiveness of health equity curricular elements.
Focus on implementation science research that highlights characteristics of feasible, replicable interventions that identify and address SDHs at the clinical level.
Develop and validate new metrics that gauge the impact of health equity interventions, with a focus on implementing patient-centered outcomes (eg, self-efficacy, social connectedness, quality of life).
Engage in research focused on integration of individual-level SDH data with population and public health outcomes.
Policy and advocacyInvest in community partnerships and health information technology to develop workflows that improve data sharing between primary care, public health, and local social services.
Partner with patients and use their stories to advocate for policy change that positively affects SDHs and their effects on health care.
Ensure that all institutional and policy decisions include an equity lens.
Advocate for alternative payment models that enable primary care delivery to integrate social services and community partnerships, such as individual- and community-level risk adjustments for SDHs.
  • SDH, social determinant of health.