Based on the experience of the Generalitat de Catalunya- Institut Català de la Salut, this national pilot project aims to implement and validate a standardized battery of Social Determinants of Health (SDH) integrated into the electronic health record system of Primary Health Care within the Portuguese National Health Service (SNS). The project seeks to develop a national interoperable model for SDH registration and monitoring, designed to support clinical and governance decision-making, promote the adjustment of health financing according to social vulnerability, and strengthen coordination between the health and social sectors, thereby contributing to greater equity and sustainability within the Portuguese health system.

The theoretical foundation is grounded in the frameworks of Dahlgren and Whitehead (1991), Diderichsen and Hallqvist (1998), and Solar and Irwin (2010), which conceptualize SDH as structural determinants of health inequities and emphasize intersectoral approaches and evidence-informed policy. According to the World Health Organization, SDH encompasses the conditions in which people are born, grow, live, work, and are age-shaped by the distribution of power, resources, and policies-and are decisive in determining population health and social justice. The lack of structured social data has constrained health systems’ capacity to effectively address population needs (Bicalho & Campos, 2024), reinforcing the strategic importance of this proposal. Inspired by the Catalan experience, where SDH codification was successfully integrated and evaluated in primary care settings (Rodoreda-Pallàs et al., 2024), this project aims to adapt and operationalize that methodology in the Portuguese context, aligned with recent research demonstrating its technical, ethical, and political feasibility.

Methodologically, the project adopts a mixed-methods approach, combining a quantitative component, focused on collecting structured and standardized indicators through the application of the SDH scale embedded in the SClínico system, and a qualitative component, consisting of semi-structured interviews with professionals involved in implementation, in order to explore perceptions, experiences, and challenges related to integrating SDH into clinical and social practice. The quantitative analysis will employ indicators of coverage, completeness, action, and health and utilization outcomes, measuring the proportion of users screened, the degree of data completeness, the rate of social vulnerability referrals, and the effects of SDH integration on reducing inequalities, improving treatment adherence, and optimizing resource use.

The strategic relevance of the project lies in its direct contribution to strengthening coordination between the health and social care sectors, enhancing the quality and personalization of care, and supporting the development of evidence-informed public policies. Expected outcomes include the creation of a validated and codified SDH registration instrument for Portugal, the development of operational dashboards and intersectoral referral protocols, the formulation of policy recommendations based on empirical evidence, and the production of scientific publications and a final report with a proposal for national scalability. Ultimately, this project contributes to building a more equitable, data-driven, and sustainable National Health Service, where health is understood holistically, incorporating social determinants as a central dimension of clinical practice, governance, and health equity.

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With the objective to increase the research activity directed towards the achievement of the United Nations 2030 Sustainable Development Goals, the possibility of associating scientific projects with the Sustainable Development Goals is now available in Ciência_Iscte. These are the Sustainable Development Goals identified for this project. For more detailed information on the Sustainable Development Goals, click here.