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SDOH-1Resources to help guide the delivery of care and training provided as part of our goal to enhance the health of the public.

Northwest Area Health Education Center (AHEC) and the Office of Continuing Medical Education (OCME) have developed goals to enhance the health of the public by intentionally addressing Social Determinants of Health (SDOH) along with health related social needs in these service lines.

  • Library Services / Information Technology
  • Continuing Professional Development
  • Graduate Medical Education
  • Health Careers and Workforce Diversity
  • Practice Support Services
  • Student and Preceptor Support
  • Community Partnerships/Collaborations

Social Determinants of Health

Social Determinants of Health are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. 


Cultural Humilities

Cultural humility is a process of self-reflection and discovery in order to build honest and trustworthy relationships.


Health Disparities

Health disparities are particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.

  1. Reducing disparities in health care
  2. Racial and Ethnic Health Disparities Related to COVID-19


Helpful Resources

    1. Addressing the Social Determinants of Health During the COVID-19 Pandemic. Sandhu, Sahil BS; Lemmon, Monica E.MD; Eisenson, Howard MD; Crowder, Carolyn MSW; Bettger, Janet prvu ScD. (2021). Family & Community Health.44(2), 78-80. Doi:10.1097/FCH.0000000000000290.
    2. Aunt Bertha Connecting People and Programs(n.d.). Retrieved May 22, 2024.
    3. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity, Samantha Artiga Follow @SArtiga2 on Twitter and Elizabeth Hinton Published: May 10, 2018. (2019, July 9). 
    4. Buying Health for North Carolinians: Addressing Nonmedical Drivers Of Health At Scale. Wortman Z, Tilson EC, Cohen MK. (2020). Health Aff (Millwood). 39(4):649-654. doi: 10.1377/hlthaff.2019.01583. PMID: 32250668. 
    5. Crisis Control. (n.d.) Retrieved May 22, 2024.
    6. Food Insecurity Screening in Primary Care: Patterns During the COVID-19 Pandemic by Encounter Modality.  Nguyen CJ, Gold R, Mohammed A, Krancari M, Hoopes M, Morrissey S, Buchwald D, Muller CJ. Am J Prev Med. 2023 Mar 23:S0749-3797(23)00151-4. doi: 10.1016/j.amepre.2023.03.014. Retrieved May 18, 2023.
    7. Healthy Lifestyle Behaviors: Nursing Considerations for Social Determinants of Health. Hirschey R, Tan K, Petermann VM, Leak Bryant A. Clinical Journal of Oncology Nursing. (2021) Oct 1;25(5):42-48. doi: 10.1188/21.CJON.S1.42-48. PMID: 34533530; PMCID: PMC8711028. Retrieved Aug 24, 2023.
    8. Medical-Legal Partnership in Western North Carolina: Addressing Social Determinants of Health Through Team-Based Care. Salter AS, Anderson GT, Gettinger J & Stigleman S. (2018). North Carolina Medical Journal, 79, 259-260. doi:10.18043/ncm.79.4.259, 10.18043/ncm.79.4.259.
    9. NCCARE360 Building Connections for a Healthier North Carolina. (n.d.). The NC Resource Platform. Retrieved May 22, 2024.
    10. Role of hospitals in addressing social determinants of health: A groundwater approach. Dave G, Wolfe MK, Corbie-Smith G. (2021). Preventive Medicine Reports. 2021 Jan 8;21:101315. doi:10.1016/j.pmedr.2021.101315.eCollection 2021 Mar. PMID: 33505842
    11. Screening for Social Determinants of Health in Free and Charitable Clinics in North Carolina. J Health Care Poor Underserved. Palakshappa D, Scheerer M, Semelka CT, Foley KL. 2020;31(1):382-397. doi: 10.1353/hpu.2020.0029. PMID: 32037338
    12. Social Determinants of Health: Addressing Barriers Through Screening, Referrals, and Care Coordination. North Carolina Medical Journal, Moore K. 2019. Sep-Oct;80(5):306-311. doi: 10.18043/ncm.80.5.306. PMID: 31471516.
    13. Social Determinants of Health in Rural Communities Toolkit - RHIhub Toolkit.(n.d.). Retrieved May 22, 2024.
    14. Social determinants of health priorities of state Medicaid programs. Chisolm DJ, Brook DL, Applegate MS, Kelleher KJBMC Health Serv Res. 2019 Mar 14;19(1):167. doi: 10.1186/s12913-019-3977-5. PMID: 30871510; PMCID: PMC6419347.
    15. Social Determinants of Health. (n.d.). Healthy People. Retrieved May 19, 2023
    16. Social Determinants of Health. NCHHSTP. CDC. (2021, Sept 30). Retrieved May 22, 2024.
    17. Social Determinants of Health: Family Physicians' Leadership Role. American family physician, 99(8), 476–477. Sherin, K., Adebanjo, T., & Jani, A. (2019).
    18. Social Determinants of Health-Relevant History, A Call to Action, An Organization's Transformational Story, and What Can Employers Do? Osmick, JM & Wilson, M. (2020). Am J Health Promot. 34(2):219-224. doi: 10.1177/0890117119896122d. PMID: 31931600.
    19. Suburban Families' Experience with Food Insecurity Screening in Primary Care Practices. PediatricsPalakshappa, D., Doupnik, S., Vasan, A., Khan, S., Seifu, L., Feudtner, C., & Fiks, A. G. (2017). 140(1), e20170320. Retrieved May 19, 2023.
    20. Telehealth and food insecurity screenings: challenges and lessons learned. Bernhardt C, King C. Mhealth. 2022 Jan 20;8:10. doi: 10.21037/mhealth-21-31. PMID: 35178441; PMCID: PMC8800207.  
    21. The Future of Medical Coding for Social Determinants of Health: North Carolina Institute of Medicine. Lyda-McDonald, B. (n.d.). Retrieved May 22, 2024.
    22. The Medical-Legal Partnership Approach to Teaching Social Determinants of Health and Structural Competency in Residency Programs. Paul EG, Curran M & Tobin Tyler E. (2017). Academic Medicine, 92, 292-298. doi:10.1097/ACM.0000000000001494, 10.1097.
    23. The Relationship Between Social Determinants of Health and Racial Disparities in COVID-19 Mortality. Journal of Racial Ethnic Health Disparities. Dalsania AK, Fastiggi MJ, & Kahlam A. (2021) Jan 5:1–8. doi: 10.1007/s40615-020-00952-y. Epub ahead of print. PMID: 33403652.
    24. The Role of US Health Plans in Identifying and Addressing Social Determinants of Health: Rationale and Recommendations. Population health management, Heisler, M., Navathe, A., DeSalvo, K., & Volpp, K. (2019). 22(5), 371–373.
    25. Think Cultural Health. (n.d.) Retrieved May 22, 2024.
    26. World Health Organization. (2021). Social determinants of health. World Health Organization. Retrieved May 22, 2024.
    27. Three Lessons About Diabetes and the Social Determinants of Health Diabetes Care. Berkowitz SA, Orr CJ.  2023 Sep 1;46(9):1587-1589. doi: 10.2337/dci23-0045. PMID: 37354315; PMCID: PMC10465981. Added November 21, 2023.
    28. Addressing Social Determinants of Health: Now Is the Time. J Natl Cancer Inst. Bona K, Keating NL. 2022 Dec 8;114(12):1561-1563. doi:     10.1093/jnci/djac137. PMID: 36130283. Added Feb 28, 2024
    29. Social determinants of health during and after coronavirus: a qualitative study. BMC Public Health. Sabet FI, Aminbeidokhti A, Jafari S. 2024 Jan 24;24(1):283. doi: 10.1186/s12889-024-17785-7. PMID: 38267896; PMCID: PMC10807155. Added Feb 28, 2024
    30. Social Determinants of Health: An Overview for the Primary Care Provider. Prim Care. Morelli V. 2023 Dec;50(4):507-525. doi:                   10.1016/j.pop.2023.04.004. Epub 2023 Jun 20. Added May 22, 2024.  





Zip code Resources

Healthy People 2030 approach to social determinants of health include the five key areas (determinants): 

  • Economic Stability
  • Education
  • Social and Community Context
  • Access to Health Care
  • Neighborhood and Built Environment

Read more here


Health disparity is a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.
Health equity is the absence of avoidable or remediable differences, allowing for the attainment of optimal health for all people . Health equity is achieved when everyone has the opportunity to attain their full health potential and no one is disadvantaged because of socially determined circumstances.
Health inequities are unfair health differences closely linked to social, environmental, or economic disadvantages that adversely affect specific groups of people.


This resource list is not intended to be an exhaustive list of all resources as it relates to SDOH. This resource list is intended to inform of SDOH, its impact on patients/clients, help guide the delivery of care and training provided.

For more information about Northwest AHEC and the OCME, please visit or call 336-713-7700


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