Skip to main content
Skip to footer



Determinants of Health

Health is more than just clinical factors. Speak with one of our experts to get started on your social determinants of health journey.

The challenge: tackling social risk factors in underserved areas

Improving the health of the populations you serve without understanding the conditions in which they live is a difficult undertaking. Studies show that non-clinical factors can impact as much as 80% of a person's overall health.1 That said, understanding the social risk factors your patient population is experiencing can be challenging. Lack of standardized data collection, incomplete data and limited resources and tools can create barriers to intervening on the social needs of populations.

While the concept of addressing social determinants of health isn’t new, organizations increasingly seek guidance and technology capabilities to address the non-medical needs of their populations through data-driven analytics and point-of-care tools. As regulatory and hospital policy pressures continue to mount, along with growing health equity priorities, understanding and responding to social risk in the population you serve is vital.

1Hood, C.M., K.P. Gennuso, G.R. Swain, and B.B. Catlin. 2016. County health rankings: Relationships between determinant factors and health outcomes. American Journal of Preventive Medicine 50(2):129-135.

Read blog: Using tech and insights to deliver more equitable patient care
The solution: going beyond clinical factors

Oracle Cerner enables care teams to support the whole person by accounting for socioeconomic and environmental factors impacting health. Whether you’re conducting wellness team outreach for at-risk patients, identifying social risk factors for pre-visit care management planning, implementing a community engagement program to address food insecurity, identifying health disparities impacting your communities, or working through your next community health needs assessment, Oracle Cerner capabilities are available to help you.

Help identify and intervene on social risk factors in your patient population through analytics and embedded care management capabilities with Cerner Determinants of Health.


Key capabilities


Community social risk insights

Gain a better understanding of the social risk factors impacting your patient population using advanced analytics, powered by clinical and determinants of health data, to inform your population health and care management strategies.


Point of care intervention

Intervene at the point of care using evidence-based screening tools and suggested goals/activities in your patient’s care plan to provide more patient-centered, equitable care.


Community investment opportunities

Make the most of your community investments by detecting areas of vulnerability down to the census block group to inform community health needs assessments, community benefit efforts and community partnership opportunities.

Examples of data considered

  • Demographic
  • Avoidable ED visits
  • United States Department of Housing and Urban Development (HUD)*
  • Readmissions
  • Chronic conditions
  • United States Department of Health and Human Services (HHS)*
  • Geospatial
  • Census Bureau*
  • Environmental Protection Agency (EPA)*

*Must have CDOH: Expanded Community Risk Insights product enhancement.

Download the Cerner Determinants of Health data sheet
The Oracle Cerner difference

Oracle Cerner is at the forefront of healthcare innovation, promoting whole-person care and advancing health equity by combining more than four decades of EHR experience, determinants of health data and geospatial mapping to zero in on underserved communities with social risks, such as food and housing insecurity. Your organization can now incorporate social risk factors into clinical care processes and community engagement program planning.


"Addressing health equity and access to care issues is a critical need for us. We can’t truly provide patient-centered, comprehensive care without understanding social risk factors our patients are experiencing. Through use of screening tools and the determinants of health dashboard, we will help enable our care managers to engage and build a trusting relationship with patients to identify and intervene on their social needs. Furthermore, we plan on leveraging the dashboard to pinpoint and prioritize areas of vulnerability in our communities and create plans to address social barriers for better health across our service lines."

April Giard, Vice President & Chief Information Officer, Northern Light Health

Learn More

Oracle Cerner has capabilities to support you regardless of where you are in your social determinants of health journey. Learn how Oracle Cerner can aid you in improving the health of the populations you serve.

Talk with an Expert