Abstract

Health care systems throughout the United States are developing programmes to address patients’ ‘social determinants of health’ – such as housing, food, income and transportation. I investigate the concepts, technologies and infrastructures through which health care systems are turning towards ‘the social’ as an object of clinical knowledge and intervention. Proponents of this movement suggest that developing the clinical capacity to prescribe social resources promises to improve the ‘value’ of care, defined as the amount of health achieved per dollar spent. I argue that initiatives to improve value through social intervention are reconstituting broader arrangements of welfare provisioning.

摘要

美国各地的医疗保健系统正在制定计划来解决患者的“健康社会决定因素”——例如住房、食物、收入和交通。我调查了医疗保健系统转向“社会”作为临床知识和干预对象的概念、技术和基础设施。这一运动的支持者认为，发展临床能力以开出社会资源处方有望提高护理的“价值”，定义为每花费一美元所获得的健康量。我认为，通过社会干预提高价值的举措正在重构更广泛的福利供应安排。