In an effort to shift the paradigm, the Center for Latino Adolescent and Family Health (CLAFH) at the Duke University School of Nursing has synthesized the best research on social determinants of health. Our team identified eight key SDOH principles that should be considered when designing and implementing programs to mitigate harmful social determinants of health.


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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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