By Daniel Stein, Karen Smith and Pierre-Gerlier Forest 

On Friday, March 13, 2020, as nearly everyone was focusing on our surreal new reality, 150+ researchers, subject matter experts, senior representatives of industry and government, and other professionals concerned with public health convened for a vital reason. A slide shown near the start of the 90-minute online session summarized its purpose succinctly: “Let’s Stop Talking and DO SOMETHING.” Check out the slides, recording, and more >>

NIC's Goal: Create a National Policy Action Agenda for SDOH

The coronavirus pandemic was front-and-center, of course, but the National Interoperability Collaborative (NIC) also had another broad, long-term objective in mind when it started planning this convening months ago, when the words “worst public health crisis in modern US history” referred to the opioid epidemic. Today, NIC’s objective remains the same; that is, to create a National Policy Action Agenda by year’s end designed to improve our nation’s too-siloed health-related systems by meaningfully integrating the Social Determinants of Health and Well-Being (SDOH) into their work. 

Two examples of why that’s so important:

  • This pandemic is demonstrating, with real immediacy, that we cannot rely on our very expensive healthcare system alone at a time like this; we need to build resilience in our communities and our people, and that requires a focus on SDOH.
  • And we are seeing a clear picture of the differential impact of this crisis on our nation’s most disadvantaged populations; remedying that reality mandates that we address the social determinants. 

The Keyword Here Is “Action”

Our goal is not just to provide another plan that people can discuss, dissect and discard. Rather, we will recommend specific, achievable actions for making progress, especially to move “upstream” toward a greater emphasis on prevention; we will delineate the actions we intend to take ourselves; and we will promote relationships and partnerships to galvanize actions by others. 

A Multisector Campaign, Join Us!

We are building a virtual team to develop the agenda, and we welcome professionals who want to join us in this ambitious effort. To find out how you can participate, write to

The NIC Action Agenda is being led by two of this blog's authors: Karen Smith, MD, former Director of the California Department of Public Health; and Daniel Stein, President of Stewards of Change Institute and Principal Investigator of NIC, which is a project of SOCI. The third author is one of our senior advisors who was a featured presenter during last Friday’s discussion. He is Pierre-Gerlier Forest, PhD, the Director of the School of Public Policy at Calgary University. Numerous other scholars and subject-matter experts in the public and private sectors are also participating in this multisector campaign, which includes: 

  • The 2020 Stewards of Change Institute National Symposium. The SDOH webinar series will be intentionally designed to shape the themes that will inform the agenda of SOCI’s symposium, which we’ll hold in late 2020 in collaboration with Stanford University’s Center for Population Health (and other Stanford schools as well). The symposium’s primary focus will be the social/human services domains and their technical connections to healthcare, public health and education (with the objective of better-incorporating the social determinants). More details about the symposium will be share on the NIC Hub.
  • The Social Determinants: A Policy Action Agenda for Tangible Progress. We plan to produce this publication in order to provide key learning, recommendations and concrete actions steps drawn from the SDOH webinar series, symposium and input from the SDOH Group and other collaborators involved in this work. We will disseminate the publication widely, take consequential actions ourselves, bring others into this effort, and create an SDOH module for the Stewards of Change Institute’s interoperability training program, which will be available later this year. 

Our Purpose, Why We Care!

Our SDOH Action Agenda, at its core, is the reason we created NIC – so that we could marshal the collective voices of experts from across disciplines and domains in order to improve communications; further learning and collaboration; and, most importantly, contribute to improving the health of populations and individuals across the country, especially for those who are at greatest risk and/or are most underserved. 

We know that the most important job for every country on earth today is to contain the coronavirus; to take every possible step to mitigate its impact on people’s lives (in too many ways to count); and to restore normalcy as soon as possible, though it obviously won’t happen soon. With that said, we also believe it’s necessary to start examining the numerous lessons that this unnerving crisis is already teaching us. That’s precisely what we’re aiming to do with one of those lessons; i.e., the myriad non-healthcare factors that clearly have to be addressed to more-effectively combat public health emergencies into the future. 

There’s been a growing understanding of the critical need to incorporate the social determinants for years. It was accelerated by the nation’s opioid epidemic, which is still with us but is understandably getting little attention for the moment. Now we face an even bigger threat that all nations unequivocally need to deal with in unprecedented ways. We’re issuing this call to action with the hope that examining and applying critical knowledge about the value of SDOH will be high on the agenda. 

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