JAMA Network January 21, 2020
The growing interest in addressing social determinants of health—nonclinical factors influencing health—raises practical issues about the way we budget for collaborative efforts across governmental departments. In particular, the expanding research on the relationship between such factors as housing, transportation, and community services and the health condition of many households indicates the importance of giving program leaders the flexibility and incentive to coordinate resources from multiple sources.
There are obstacles, however. Program leaders and budget officials normally are held accountable only for reaching their own department’s goals, not the goals of other departments. For instance, transportation or housing officials typically are not judged on the effect their budgeting decisions have on Medicaid or Medicare. Indeed, many efforts to address social determinants...
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