Community and public health guidance and resources
Social determinants of health shape health long before patients enter the exam room.
Family medicine and public health have a shared goal of improving the health of families and communities. No other specialty treats a broader range of conditions than family medicine and none offers dynamic, longitudinal care to so many people.
This continuity and breadth of care give family physicians a unique opportunity to recognize how factors such as housing, food access, education, employment and social connection affect health, and to respond through screening, care planning and community partnership. Recognizing these influences allows family physicians to tailor care, connect patients with supportive services and address barriers that might otherwise limit treatment success.
Clinical preventive service recommendations
U.S. Preventive Services Task Force (USPSTF) recommendations
Intimate partner violence (IPV) and caregiver abuse are common and can cause serious physical and long-term health consequences. The USPSTF finds screening women of reproductive age, including those who are pregnant or postpartum, for IPV and connecting those who screen positive to supportive interventions provides a moderate net benefit. However, current evidence is insufficient to determine whether routine screening for abuse or neglect in elderly or vulnerable adults provides more benefit than harm.
STIs are common, often asymptomatic and can lead to serious complications such as infertility, cancer and HIV. Behavioral counseling that addresses safer sex practices, condom use and risk reduction can lower the chance of acquiring STIs. The USPSTF finds a moderate net benefit and recommends behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs.
Hepatitis B virus infection during pregnancy can be passed to the infant during birth, increasing the child’s risk of lifelong chronic infection, cirrhosis and liver cancer. Screening pregnant patients allows timely treatment and case management to prevent perinatal transmission. Evidence shows these interventions are effective. The USPSTF concludes screening provides a substantial net benefit and recommends universal hepatitis B screening at the first prenatal visit.
Chronic hepatitis B virus infection often goes undiagnosed and can lead to cirrhosis, liver failure and liver cancer. People at higher risk include those born in regions where hepatitis B virus is common, people who inject drugs, men who have sex with men, people with HIV and close contacts of infected persons. The USPSTF finds screening adolescents and adults at increased risk provides a moderate net benefit, allowing earlier treatment and monitoring to reduce long-term complications.
Hepatitis C virus infection is a leading cause of chronic liver disease and liver-related death in the United States, with rising rates driven largely by injection drug use. Many people are asymptomatic until serious liver damage occurs. The USPSTF finds screening adults aged 18 to 79 provides a substantial net benefit, enabling early treatment that can cure infection and prevent long-term complications.
HIV infection remains a major public health issue. Many people are unaware they are infected until serious illness develops. Early diagnosis and treatment with antiretroviral therapy improves survival, reduces complications and lowers the risk of transmission, including from mother to child during pregnancy and delivery. The USPSTF finds screening provides a substantial net benefit and recommends routine HIV screening for adolescents and adults aged 15 to 65, younger or older persons at increased risk and all pregnant persons, including those with unknown status at delivery.
HIV remains a serious, lifelong infection with major health consequences, making prevention a key priority. Preexposure prophylaxis (PrEP) with antiretroviral medication is highly effective at preventing HIV in people who do not have HIV but are at increased risk. The USPSTF finds substantial net benefit and recommends clinicians offer PrEP to adolescents and adults at increased risk of acquiring HIV to reduce their chance of infection.
Lifestyle medicine
Lifestyle medicine is a medical specialty that uses lifestyle change as a primary modality to treat chronic conditions. This approach applies medical, behavioral, environmental and motivational principles to prevent, treat and reverse chronic conditions.
Putting lifestyle medicine into action
This page supports family physicians as they address the following five main domains of lifestyle medicine:
Connectedness
Movement
Nutrition
Recovery
Substance use
When addressing all domains together, lifestyle medicine can address multiple chronic diseases simultaneously.
Family physicians are ideally positioned to champion and prescribe lifestyle medicine in the clinic. They can also work collaboratively with community health professionals to help patients sustain healthy behaviors over time.
- Incorporating lifestyle medicine into everyday family practice: Implementation guide and resources (PDF)
- Leading change: Incorporating lifestyle medicine into everyday practice (PDF)
- Practice assessment for opportunities to incorporate lifestyle medicine (PDF)
- Additional tools for the lifestyle medicine team (PDF)
- Reimbursement and coding for lifestyle medicine (PDF)
- Lifestyle medicine assessment tool (PDF)
- Lifestyle medicine assessment instructions and tool (Mac)
- Lifestyle medicine assessment instructions and tool (PC)
Social determinants of health
Family physicians sit at the front line of community health, addressing social drivers of health, preventing disease and supporting healthier environments for patients and families. Community health trends, from chronic disease burden to environmental exposures, continue to evolve and shape the needs of the populations you serve.
The American Academy of Family Physicians (AAFP) provides evidence-based resources on population health, preventive services, environmental health and community-level interventions. Use these tools to strengthen partnerships, address health inequities and promote healthier communities.
What drives health outcomes?
Health is shaped more by social and behavioral factors than by medical care alone. Identifying these factors will allow you to improve patient outcomes and extend your impact beyond the clinic walls, improving places where patients live, learn, work, and play.
Social and economic environment: Nonmedical conditions that significantly impact health and quality of life.
Health behavior: Daily habits, actions and attitudes that influence health and quality of life.
Clinical care: Any evidence-based medical treatment provided by health professionals.
Physical environment: External surroundings and conditions in which people live that influence health and quality of life.
Teaming up with public health (PDF) is a primer to help you build on the public health work you may already be doing and identify new opportunities to collaborate with public health.
Family physician public health partnership guide (PDF) builds upon the AAFP’s Teaming up with Public Health series, offering the opportunity to advance community health efforts by enabling family physicians to provide person-centered, team-based and community-aligned care to achieve better health, better care and lower costs.
Family physician community collaboration guide (PDF) continues AAFP’s Teaming up with Public Health series, offering practical information for family physicians to identify a starting point for collaborating with communities.
Related resources
Scaling Whole Health Strategies in Primary Care | Action Brief
Patient resources
The AAFP patient education website FamilyDoctor.org provides these patient-facing resources.