Epidemiology of Health-Related Social Needs Screening and Positivity in a Multistate Health System.

Healthcare systems worldwide are at a critical crossroads, and this transition is particularly pronounced in primary healthcare []. Primary healthcare is undergoing profound transformation, driven by escalating clinical and social complexity, rapid technological innovation, and persistent health inequalities, underscoring that access to health and its outcomes remain unevenly distributed. Contemporary societies are evolving at unprecedented speed, mainly under pressure of five major stress factors: demographic change, climate instability, infectious disease pandemics, economic instability, increasing migration and resulting population superdiversity. Each of these forces amplifies the complexity of health problems presented in primary care, the decision-making processes of clinicians, and the adaptive capacity required from care systems []. Within this changing landscape, the role of primary care and family physicians is being fundamentally transformed. Routine and predictable aspects of care are increasingly supported or substituted by telehealth, digital tools, and even patient-led self-management. The clinical core that remains in family physicians’ care is shifting towards more complex, uncertain, multimorbid, psychosocial health needs—domains that require interprofessional collaboration and integrated care []. As services continue to transition from hospitals to community-based settings, primary care professionals become key coordinators of this transmural care. Their responsibilities now extend beyond individual patient encounters to include population-level care, patient group management, and attention to lived experience, wellbeing, and social context. Family physicians are expected to act as connectors across multiple health and social care systems, integrating both clinical care and broader dimensions of health and wellbeing.