Learning in PINNs: Phase transition, diffusion equilibrium, and generalization.

Social determinants of health (SDoH) encompass the non-medical conditions and environments under which people are born, live, work, and age. The US Department of Health and Human Services categorizes SDoH into five broad categories: economic stability, education, social and community context, health and health care, and neighborhood and built environment. These factors significantly affect healthcare disparities, with life expectancy differing by 14.6 years for men and 10.1 years for women between the highest and lowest income groups in the United States. Moreover, SDoH contribute to disparities in health outcomes across race, ethnicity, geography, and socioeconomic status (SES). Despite their importance, addressing SDoH within healthcare remains a persistent challenge due to upstream factors, limited workforce capacity, and funding constraints. Clinicians often support the concept of SDoH screening in a clinical setting but routinely feel incapable of addressing the identified needs, while others debate that screening in the absence of social solutions is potentially harmful. Evidence suggests that screening and addressing SDoH in a healthcare setting is effective at improving healthcare outcomes (e.g., smoking cessation, improving hypertension, exercise compliance, and depression), and may reduce healthcare cost and utilization. Given the apparent gap in available solutions to address these needs, there remains a disconnect between identifying social needs and addressing them in a healthcare context. There is a need for scalable, community-driven models to address health related social needs (HRSNs) and support healthcare systems in achieving innovative and equitable health solutions. While various models address HRSNs through screening and service linkage, few leverage the social and relational capital of community members, a distinctive approach aimed at creating sustainable impact. Social and relational capital consists of the relationships and social bonds that individuals possess and leverage for their needs. This support increases engagement in health-promoting behaviors, adherence to treatment plans, and access to timely medical care, improving health outcomes.