Social Determinants of Health: If You Aren't Measuring Them, You Aren't Seeing the Big Picture.

Clinicians often assume that interventions directly influence the recovery of patients with musculoskeletal impairments. In reality, other factors may influence recovery more than the direct treatment provided. The most powerful factor may be upstream effects such as economic stability, education, health and health care, neighborhood and built environment, and social and community context-commonly termed the social determinant of health (SDH). Although a single empirical pathway linking the collective impacts of the SDH to musculoskeletal health outcomes has not been established, our view is that they exert tremendous effects on physical therapy outcomes in practice and research. In this Viewpoint, the authors discuss the SDH and argue that recognizing the impact of SDHs on health behavior is vital to seeing the whole picture related to musculoskeletal recovery. .