scholarly journals Teaching Family Medicine Residents How to Identify and Address Social Determinants of Health

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Lisa Schoenberger ◽  
Rajaa Mourabet ◽  
Binju Bose ◽  
Qian Gu ◽  
Benita Benjamin ◽  
...  
Keyword(s):  
Family Medicine ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Screening Tool ◽  
Primary Care Providers ◽  
Practical Experience ◽  
Social Needs ◽  
Determinants Of Health ◽  
Care Providers ◽  
Family Medicine Residents

Introduction: This educational program aimed to teach family medicine residents how to address social determinants of health. The literature reviewed suggested that curricula addressing social needs of patients were sporadic and failed to provide residents with practical ways to apply the knowledge. The program objectives were to provide residents with a thorough understanding of social determinants of health and to provide a practical experience where they could address social needs. Methods: The program consisted of four didactic sessions in which the residents discussed why addressing social determinants of health is important, designed a screening tool, and were educated on how to assess and communicate with patients. As a longitudinal experience, the residents used the screening tool in their clinic and connected patients with resources. We performed a mixed-methods data analysis to determine if program goals were met. Results: Survey data showed a statistically significant change in the comfort, understanding, and consistency of addressing social determinants of health. Reflections showed similar results. Residents recognized the importance of being aware of social needs, having conversations with patients about their needs, and considering cost when they implement treatment plans.  Conclusions: Family medicine residents are the future primary care providers for our communities. Therefore, it is important to equip them with the knowledge and ability to address all of the factors affecting their patients’ health. Graduates will be able to apply this knowledge to their future patients, and educators can be assured family physicians have the skills to address social determinants of health.

scholarly journals Measuring social determinants of health and their impact on service use and medical complexity

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dan Chateau ◽  
Alan Katz ◽  
Chelsey McDougall ◽  
Carole Taylor ◽  
Scott McCulloch
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Complexity ◽  
Primary Care Providers ◽  
Determinants Of Health ◽  
Care Providers ◽  
Complex Patients ◽  
Medical Complexity

IntroductionPopulation based data on the social determinants of health are not widely available, despite a wide body of evidence pointing to their importance. The Mantioba Population Research Data Repository offers a unique opportunity to leverage data from multiple government departments to assess the relationship between measurable social determinants and health. Objectives and ApproachUsing population based data from health, small area level census survey questions, social assisitance, education, social housing, child protective services and justice, linked at the individual level, we measured indicators of social complexity and mapped them in the province of Manitoba. Individuals with high level of social complexity were then compared with indicators of medical complexity and/or high use of medical services to determine the degree of overlap between these attributes of individuals. A matched group of individuals without any of the measured social complexities was developed and the number and reason for visits to primary care providers was compared. ResultsThe rate of individuals having three or more social complexities varied from a low of ~7% to a high of 35%, depending on the geographic location. High residential mobiity, involvement with the justice system and history of social assistance were the most frequent (>15%). Individuals with social complexities tended to be younger and live in poorer neighbourhoods than medically complex individuals or high users of health services. Socially complex persons had on average 5.5 primary care visits annually, compared to only ~3.5 for matched individuals with no social complexities. The overlap with high users of health services was slight (14.4%) and depended on the characteristics of the population. The overlap with medically complex patients ws higher (16.2%), particularly when medical complexity included mental health related diagnoses (20.4%). Conclusion/ImplicationsThe proportion of individuals with social complexities is large, and a substantial number have multiple risk factors. These individuals are for the most part a unique group, distinct from medically complex patients. Different strategies for care may be necessary to promote and sustain mental and physical health and wellbeing.

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

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.

scholarly journals Universal Screening of Social Determinants of Health at a Large US Academic Medical Center, 2018

2020 ◽  
Vol 110 (S2) ◽  
pp. S219-S221
Author(s):  
Dodi Meyer ◽  
Eva Lerner ◽  
Alex Phillips ◽  
Katarina Zumwalt
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Universal Screening ◽  
Medical Center ◽  
Academic Medical Center ◽  
Social Needs ◽  
Determinants Of Health ◽  
System Level ◽  
Presbyterian Hospital ◽  
Academic Medical

Universal screenings for social determinants of health (SDOH) are feasible at the health system level and enable institutions to identify unmet social needs that would otherwise go undiscovered. NewYork-Presbyterian Hospital implemented SDOH screenings together with clinical screenings in four outpatient primary care sites. Aligning SDOH screening with clinical screening was crucial for establishing provider buy-in and ensuring sustainability of screening for SDOH. Despite some challenges, universal screening for SDOH has allowed NewYork-Presbyterian Hospital to identify unmet needs to improve population health.

scholarly journals Anchor Institutions: Best Practices to Address Social Needs and Social Determinants of Health

2020 ◽  
Vol 110 (3) ◽  
pp. 309-316
Author(s):  
Howard K. Koh ◽  
Amy Bantham ◽  
Alan C. Geller ◽  
Mark A. Rukavina ◽  
Karen M. Emmons ◽  
...  
Keyword(s):  
Best Practices ◽  
Community Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Web Sites ◽  
Lessons Learned ◽  
Social Needs ◽  
Determinants Of Health ◽  
Current Status ◽  
Anchor Institutions

“Anchor Institutions”—universities, hospitals, and other large, place-based organizations—invest in their communities as a way of doing business. Anchor “meds” (anchor institutions dedicated to health) that address social needs and social determinants of health have generated considerable community-based activity over the past several decades. Yet to date, virtually no research has analyzed their current status or effect on community health. To assess the current state and potential best practices of anchor meds, we conducted a search of the literature, a review of Web sites and related public documents of all declared anchor meds in the country, and interviews with 14 key informants. We identified potential best practices in adopting, operationalizing, and implementing an anchor mission and using specific social determinants of health strategies, noting early outcomes and lessons learned. Future dedicated research can bring heightened attention to this emerging force for community health.

Call to Action: Addressing Social Determinants of Health in Pharmacy Practice

2021 ◽  
pp. 106002802110408
Author(s):  
Julie Kalabalik-Hoganson ◽  
Ayse Elif Ozdener-Poyraz ◽  
Denise Rizzolo
Keyword(s):  
Health Outcomes ◽  
Social Determinants Of Health ◽  
Health Risks ◽  
Social Determinants ◽  
Pharmacy Practice ◽  
Social Needs ◽  
Determinants Of Health ◽  
Call To Action ◽  
Physician Practices ◽  
The Impact

Social determinants of health (SDOH) are conditions in which individuals are born, live, work, learn, play, and age that affect health, risks, functioning, and outcomes. SDOH are recognized barriers to care, risk factors for certain diseases, and associated with poorer health outcomes. Screening for SDOH in physician practices and hospitals is reportedly low. The accessibility of pharmacists and established relationships with patients make pharmacy settings ideal for identifying and mitigating social needs. An evaluation of the impact of SDOH on health outcomes and opportunities for pharmacists to embed screening into practice is warranted.

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