Stanford study supports SDOH investment

Health care accounts for just 5% to 15% in the variance in premature death

Stanford researchers estimate that health care only accounts for between 5% and 15% of the variation in premature death, according to findings they reported in the May-June issue of the Annals of Family Medicine. In results that justify the increasing attention on the social determinants of health, the researchers reported that social circumstances and behavior patterns have a much larger effect--up to 65% in some models.

The researchers, Robert Kaplan and Arnold Milstein, did not do original research. Rather, they looked at four different existing methods and models for calculating the effects that health care and other factors have on premature death.

While there was some variation, they found that the estimates of health care's contribution landed in the 5%–15% range.

Estimates of the contribution of social and behavioral factors varied quite a bit--an indication, perhaps, that there is some educated guesswork going on. One method's figuring pegged the effect of social circumstances as accounting for 15% of the difference in early mortality. Another found that behavior patterns accounted for 65% of the variance.

Even so, the large difference between health care's contribution and social and behavioral factors is notable. Proponents of addressing social determinants of health may take some encouragement from this study.