Using Social Determinants Screening/Mapping Tools to Identify Needs and Resources for Student-Run Free Clinic Patients

Background: Social determinants of health have been well accepted as contributing to health outcomes. They are a vital aspect of health care delivery and must be a consideration, especially among free clinic populations. Social determinants of health have also become a required element of medical school curricula. The Student Outreach to Area Residents Student-Run Free Clinic based out of Northeast Ohio Medical University piloted a student-led program that implemented social determinants of health screening and community resource referral as a part of integrated health care delivery for all its patients. Methods: We described the development of a screening tool, protocol, and creation of community resource referral materials. We also described the tracking of patient-reported needs and mapping of location and accessibility of community resources. One hundred patients were surveyed through convenience sampling, and results were used for program improvement. Results/Conclusion: After collecting and analyzing survey results, it was found that the 2 most frequently requested determinants were mental health and utilities services, and the most available community resource was emergency food services. We also mapped these results by zip code and found gaps between need and distribution of services. We demonstrated the utility of mapping to identify points of improvement for the future. We also provided lessons learned related to effective social determinants of health screening, community resource referral, and overall program implementation in student-run free clinics. We further explained the benefits of including similar student-led programs as a way for students to gain practical experience related to social determinants of health.

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Social Determinants of Health and Health Care Delivery: African American Women’s T2DM Self-Management

Clinical Nursing Research ◽

10.1177/1054773820916981 ◽

2020 ◽

pp. 105477382091698

Author(s):

Judith M. Ochieng ◽

Janice D. Crist

Keyword(s):

Health Care ◽

African American ◽

Social Determinants Of Health ◽

Health Care Delivery ◽

Social Determinants ◽

Care Delivery ◽

Healthcare Delivery ◽

Healthcare Services ◽

Determinants Of Health ◽

Self Management

African American (AA) women have high prevalence of Type 2 diabetes mellitus (T2DM) and complications. No studies have been conducted about how social determinants of health and health care delivery affect their T2DM self-management. The purpose was to describe how social determinants of health and healthcare delivery may influence AA women’s T2DM self-management using qualitative descriptive methodology ( N = 10). Ten participants were interviewed. Participants’ geographical location, education, level of income, health literacy, and systemic racism, that is, healthcare delivery services, for example, inadequate healthcare services, providers’ assumptions about the patient’s knowledge of diabetes, providers’ attitudes toward patients, and stigma related to diabetes as a disease were identified. Understanding the role of social determinants of health and the health care delivery system in influencing T2DM self-management is a powerful tool for providers and practitioners for improving practice and health care policies to decrease health disparities and improve health outcomes among AA women with T2DM.

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What does social isolation have to do with my arthritis? Patient and provider views of the implementation of an electronic Social Determinants of Health risk assessment tool

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641164 ◽

2020 ◽

Vol 64 (1) ◽

pp. 707-710

Keyword(s):

Electronic Health Record ◽

Social Determinants Of Health ◽

Social Determinants ◽

Assessment Tool ◽

Determinants Of Health ◽

Health Record ◽

Institute Of Medicine ◽

Patient Reported ◽

Item Responses ◽

Electronic Health

Social Determinants of Health (SDoH) are the conditions in which people are born, live, learn, work, and play that can affect health, functioning, and quality-of-life outcomes. The Institute of Medicine charged healthcare institutions with capturing and measuring patient SDoH risk factors through the electronic health record. Following the implementation of a social determinants of health electronic module across a major health institution, the response to institutional implementation was evaluated. To assess the response, a multidisciplinary team interviewed patients and providers, mapped the workflow, and performed simulated tests to trace the flow of SDoH data from survey item responses to visualization in EHR output for clinicians. Major results of this investigation were: 1) the lack of patient consensus about value of collecting SDOH data, and 2) the disjointed view of patient reported SDoH risks across patients, providers, and the electronic health record due to the way data was collected and visualized.

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Impact of COVID-19 on social determinants of health for adults with cystic fibrosis

Therapeutic Advances in Respiratory Disease ◽

10.1177/17534666211037459 ◽

2021 ◽

Vol 15 ◽

pp. 175346662110374

Author(s):

Dana Albon ◽

Heather Bruschwein ◽

Morgan Soper ◽

Rhonda List ◽

Deirdre Jennings ◽

...

Keyword(s):

Health Care ◽

Cystic Fibrosis ◽

Social Determinants Of Health ◽

Social Determinants ◽

Social Issues ◽

Determinants Of Health ◽

Care Utilization ◽

Health Questionnaire ◽

Improvement Project ◽

The Impact

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.

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Cuban health care and social determinants of health: just too good for the US?

The Health of Nations ◽

10.5040/9781350223219.ch-016 ◽

2012 ◽

Keyword(s):

Health Care ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

The Us ◽

Good For

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Social determinants of health in mental health care and research: a case for greater inclusion

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocz049 ◽

2019 ◽

Vol 26 (8-9) ◽

pp. 895-899 ◽

Cited By ~ 3

Author(s):

Joseph J Deferio ◽

Scott Breitinger ◽

Dhruv Khullar ◽

Amit Sheth ◽

Jyotishman Pathak

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Social Determinants Of Health ◽

Language Processing ◽

Social Determinants ◽

Ad Hoc ◽

Extraction Methods ◽

Determinants Of Health ◽

Independent Risk Factors

Abstract Social determinants of health (SDOH) are known to influence mental health outcomes, which are independent risk factors for poor health status and physical illness. Currently, however, existing SDOH data collection methods are ad hoc and inadequate, and SDOH data are not systematically included in clinical research or used to inform patient care. Social contextual data are rarely captured prospectively in a structured and comprehensive manner, leaving large knowledge gaps. Extraction methods are now being developed to facilitate the collection, standardization, and integration of SDOH data into electronic health records. If successful, these efforts may have implications for health equity, such as reducing disparities in access and outcomes. Broader use of surveys, natural language processing, and machine learning methods to harness SDOH may help researchers and clinical teams reduce barriers to mental health care.

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Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health

Annual Review of Public Health ◽

10.1146/annurev-publhealth-090419-102204 ◽

2020 ◽

Vol 42 (1) ◽

Author(s):

Matthew W. Kreuter ◽

Tess Thompson ◽

Amy McQueen ◽

Rachel Garg

Keyword(s):

Public Health ◽

Health Care ◽

Social Determinants Of Health ◽

Social Services ◽

Social Determinants ◽

Safety Net ◽

Social Needs ◽

Determinants Of Health ◽

Health Improvement ◽

Health Care Settings

There has been an explosion of interest in addressing social needs in health care settings. Some efforts, such as screening patients for social needs and connecting them to needed social services, are already in widespread practice. These and other major investments from the health care sector hint at the potential for new multisector collaborations to address social determinants of health and individual social needs. This article discusses the rapidly growing body of research describing the links between social needs and health and the impact of social needs interventions on health improvement, utilization, and costs. We also identify gaps in the knowledge base and implementation challenges to be overcome. We conclude that complementary partnerships among the health care, public health, and social services sectors can build on current momentum to strengthen social safety net policies, modernize social services, and reshape resource allocation to address social determinants of health. Expected final online publication date for the Annual Review of Public Health, Volume 42 is April 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Patient-Reported Experiences in Discussing Prescribed Medications with a Health Care Provider: Evidence for Racial/Ethnic Disparities in a Large Health Care Delivery System

Population Health Management ◽

10.1089/pop.2018.0206 ◽

2020 ◽

Vol 23 (1) ◽

pp. 78-84

Author(s):

Sukyung Chung ◽

Qiwen Huang ◽

Joyce LaMori ◽

Dilesh Doshi ◽

Robert J. Romanelli

Keyword(s):

Health Care ◽

Health Care Provider ◽

Delivery System ◽

Health Care Delivery ◽

Care Provider ◽

Care Delivery ◽

Ethnic Disparities ◽

Health Care Delivery System ◽

Patient Reported ◽

Racial Ethnic

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Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-623420140000600017 ◽

2014 ◽

Vol 48 (spe) ◽

pp. 119-125 ◽

Cited By ~ 3

Author(s):

Celia Maria Sivalli Campos ◽

Bárbara Ribeiro Buffette Silva ◽

Deisi Cristine Forlin ◽

Carla Andréa Trapé ◽

Iara de Oliveira Lopes

Keyword(s):

Health Care ◽

Primary Health Care ◽

Social Determinants Of Health ◽

Social Determinants ◽

Home Visit ◽

Care Service ◽

Health Care Service ◽

Health Needs ◽

Determinants Of Health ◽

Primary Health

Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.

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