scholarly journals Addressing Social Determinants While Social Distancing: The Development of an Evidence-Based Social Needs Screening for a Telehealth Setting

2021 ◽  
Author(s):  
Ruby Reed ◽  
María Suárez-Nieto ◽  
Jiwoo Lee ◽  
Neil Wary ◽  
Songnan Wang ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Patient Population ◽  
Clinical Care ◽  
Community Organizations ◽  
Social Needs ◽  
Determinants Of Health ◽  
Evidence Based ◽  
Free Clinics ◽  
The Social

Effectively addressing social determinants of health in clinical care can be challenging, and screening for such social needs is often overlooked. The COVID-19 pandemic has exacerbated health disparities and the impacts of social determinants of health, increasing the importance of both effective screening and intervention to address social needs. In response, the student-run free clinics at Stanford University sought to meet this need amongst our patient population by developing an evidence-based social needs screening (SNS) and referral protocol and integrating it into our novel telehealth model. The new protocol was implemented significantly more consistently compared to our previous checklist-based SNS, and more need was identified amongst our patient population than with the checklist-based, pre-pandemic screen. The new screening and referral protocol facilitated comprehensive patient care that addresses the social determinants of health in the clinical setting by improving our ability to identify patient social needs and refer such patients to community organizations. In describing the development, design, and implementation of this SNS, we hope to provide an example strategy for addressing social determinants of health within a student-run free clinic setting, and to encourage other student-run clinics and/or free clinics to similarly expand locally relevant social needs services.

Abstract P385: Pregnancy Care Must Do More to Meet Women's Social Needs: A Systematic Review of Interventions Addressing the Social Determinants of Health

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ana Reyes ◽  
Rabih Dahdouh ◽  
Precious Akanyirige ◽  
Araceli Estrada ◽  
Maria R Young ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Needs ◽  
Determinants Of Health ◽  
Cochrane Library ◽  
Risk Screening ◽  
Pregnancy Care ◽  
The Social ◽  
In Pregnancy

Introduction: Consistent evidence has shown that the social determinants of health (SDoH) play an important role in shaping overall health. As health systems become more focused on improving the health of populations, there is an urgent need for interventions that address upstream factors such as the social determinants of health. Such interventions have not been widely studied and even less work exists in the realm of maternal health. But as maternal and infant mortality remain critical issues, there is great opportunity for the study and development of interventions to address social needs in pregnancy care. Hypothesis: We assessed the hypothesis that most existing interventions addressing the social needs of pregnant women would focus only on identifying social risks, while fewer would connect patients with resources in the community. We expected that most studies would not provide evaluations of effectiveness. Methods: We conducted a database search of MEDLINE, Embase, Cochrane Library, CINAHL, Scopus, and Web of Science to capture literature published between January 1970 and April 2019. A team of reviewers screened titles and abstracts for interventions that were issued in a clinical setting and addressed at least one SDoH as defined by the World Health Organization. Results: Preliminary results revealed 25 studies. All consisted of some form of risk screening and four included a referral process. Interventions addressing intimate partner violence were most numerous followed by psychosocial factors and cigarette smoking. Financial needs were assessed in one study. Eight studies included an evaluation process. Staff carrying out the interventions were primarily research staff, nurse practitioners or nurse midwives. Conclusions: In conclusion, more must be done to connect pregnant women with social resources. As unmet social needs put women at higher risk for poor outcomes in pregnancy, action should be taken to more seamlessly integrate social needs interventions into clinical workflows. Focus should expand beyond traditional social risk screening to capture a wider range of needs including financial stability, housing, and transportation. These are particularly important during pregnancy because adequate prenatal care requires women to be more engaged with the health care system than they would to maintain baseline health.

scholarly journals Global Health with Justice: Controlling the Floodgates of the Upstream Determinants of Health through Evidence-Based Law

2020 ◽  
Vol 13 (1) ◽  
pp. 4-9
Author(s):  
John Coggon ◽  
Lawrence O Gostin
Keyword(s):  
Global Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Evidence Based ◽  
Special Issue ◽  
The Social ◽  
Georgetown University ◽  
The Subject ◽  
Upstream Determinants

Abstract This article introduces a special issue on the legal determinants of health, following the publication of the Lancet–O’Neill Institute of Georgetown University Commission’s report on the subject. We contextualize legal determinants as a significant and vital aspect of the social determinants of health, explain the work of the Lancet–O’Neill Commission and outline where consequent research will usefully be directed. We also introduce the papers that follow in the special issue, which together set out in greater detail the work of the Commission and critically engage with different aspects of the report and the application of its findings and recommendations.

scholarly journals Screening for poverty and intervening in a primary care setting: an acceptability and feasibility study

2019 ◽  
Vol 36 (5) ◽  
pp. 634-638
Author(s):  
Andrew D Pinto ◽  
Madeleine Bondy ◽  
Anne Rucchetto ◽  
John Ihnat ◽  
Adam Kaufman
Keyword(s):  
Primary Care ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Determinants Of Health ◽  
Health Concern ◽  
Evidence Based ◽  
Health Providers ◽  
Financial Benefits ◽  
The Social

Abstract Background A movement is emerging to encourage health providers and health organizations to take action on the social determinants of health. However, few evidence-based interventions exist. Digital tools have not been examined in depth. Objective To assess the acceptability and feasibility of integrating, within routine primary care, screening for poverty and an online tool that helps identify financial benefits. Methods The setting was a Community Health Centre serving a large number of low-income individuals in Toronto, Canada. Physicians were encouraged to use the tool at every possible encounter during a 1-month period. A link to the tool was easily accessible, and reminder emails were circulated regularly. This mixed-methods study used a combination of pre-intervention and post-intervention surveys, focus groups and interviews. Results Thirteen physicians participated (81.25% of all) and represented a range of genders and years in practice. Physicians reported a strong awareness of the importance of identifying poverty as a health concern, but low confidence in their ability to address poverty. The tool was used with 63 patients over a 1-month period. Although screening and intervening on poverty is logistically challenging in regular workflows, online tools could assist patients and health providers identify financial benefits quickly. Future interventions should include more robust follow-up. Conclusions Our study contributes to the evidence based on addressing the social determinants of health in clinical settings. Future approaches could involve routine screening, engaging other members of the team in intervening and following up, and better integration with the electronic health record.

Utilizing a Data-to-Action Approach to Cultivate Policy Research and Advocacy Skills in Community-Engaged Health Promotion Courses

2021 ◽  
pp. 237337992110358
Author(s):  
Ameena Batada ◽  
Audrey E. Thomas ◽  
Danielle Holtz
Keyword(s):  
Health Promotion ◽  
Service Learning ◽  
Social Determinants Of Health ◽  
Policy Change ◽  
Social Determinants ◽  
Opportunity To Learn ◽  
Community Organizations ◽  
Lessons Learned ◽  
Determinants Of Health ◽  
The Social

Community-engaged (or service) learning is a common approach in health promotion and undergraduate education and can provide students with an opportunity to learn about the social determinants of health and policy change and advocacy. Students can support organizations with policy advocacy to promote more equitable resource allocation in communities close to campus and take these skills into their future professions. This article presents an overview of and the lessons learned from a “data-to-action” approach, as well as a summary of students’ perceptions on being part of a class taking this approach. In partnership with community organizations advocating for policy change, a data-to-action approach engages and guides students in primary and/or secondary data collection, analysis, and reporting. Through the projects described in this article, students observed how policy change can affect the social determinants of health, and they contributed to advocacy efforts for policy change, such as extending bus routes, reducing the marketing and sales of tobacco, and prioritizing resources for people who are houseless. Overall, students reported that they gained familiarity with local communities and with research and other professional skills. A data-to-action approach has the potential to benefit both students and community organizations’ local advocacy efforts.

Addressing the Social Determinants of Health

2019 ◽  
Vol 101 (4) ◽  
pp. 357-395 ◽  
Author(s):  
Saty Satya-Murti ◽  
Jennifer Gutierrez
Keyword(s):  
Twentieth Century ◽  
Los Angeles ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Activism ◽  
Determinants Of Health ◽  
Medical Attention ◽  
Community Center ◽  
Early Twentieth Century ◽  
The Social

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.

Health Disparities and the Social Determinants of Health: Ethical and Social Justice Issues

2019 ◽  
pp. 265-276
Author(s):  
Sridhar Venkatapuram
Keyword(s):  
Health Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Global Justice ◽  
Social Epidemiology ◽  
Social Groups ◽  
Determinants Of Health ◽  
Housing Conditions ◽  
Early Infant ◽  
The Social

The term health disparities (also called health inequalities) refers to the differences in health outcomes and related events across individuals and social groups. Social determinants of health, meanwhile, refers to certain types of causes of ill health in individuals, including lack of early infant care and stimulation, lack of safe and secure employment, poor housing conditions, discrimination, lack of self-respect, poor personal relationships, low community cohesion, and income inequality. These social determinants stand in contrast to others, such as individual biology, behaviors, and proximate exposures to harmful agents. This chapter presents some of the revolutionary findings of social epidemiology and the science of social determinants of health, and shows how health disparities and social determinants raise profound questions in public health ethics and social/global justice philosophy.

scholarly journals The ADI-3: a revised neighborhood risk index of the social determinants of health over time and place

2021 ◽  
Author(s):  
Kristen A. Berg ◽  
Jarrod E. Dalton ◽  
Douglas D. Gunzler ◽  
Claudia J. Coulton ◽  
Darcy A. Freedman ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Risk Index ◽  
Determinants Of Health ◽  
The Social ◽  
Neighborhood Risk ◽  
Over Time
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