A new framework
for mitigating harmful SDOH

The DUSON/CLAFH framework serves as a roadmap for educators, practitioners, researchers, policymakers and other stakeholders designing programs to mitigate harmful SDOH and bolster strength-based resilience factors that set communities up to thrive despite structural adversity.

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Dhar A, Bhatt J, Batra N, Rush B, Gerhardt W, Davis A. US health care can’t afford health inequities. Deloitte. Published June 22, 2022. Accessed November 17, 2022.


Thimm-Kaiser M, Benzekri A, Guilamo-Ramos V. Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation. Milbank Q. 2023;101(2):0416.

SDOH are usually grouped into five broad, static domains.


Education Access
and Quality

Health Care Access
and Quality

Neighborhood and
Built Environment

Social and
Community Context

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