Screening for Social Determinants of Health in Daily Practice

VINITA MAGOON, DO, JD, MBA, MPH, CMQ

Fam Pract Manag. 2022 Mar-Apr;29(2):6-11.

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Having a clear picture of your patients' socioeconomic needs is key to improving their health outcomes. Lack of food, housing, clean water, transportation, and employment, among other challenges, can have significant downstream effects on otherwise healthy patients. For those with chronic conditions, socioeconomic factors are even more crucial because they hinder lifestyle changes that are often first-line treatments for those conditions. For example, patients with type 2 diabetes may be unable to control their A1C if they cannot afford their medications or do not have access to healthy groceries.

Non-medical conditions that significantly affect health and quality of life are called social determinants of health (SDOH). According to the U.S. Department of Health and Human Services, SDOH fall into five categories: economic stability, health care access and quality, education access and quality, neighborhood and built environment, and social and community context.1 Within these categories are basic needs such as safety, transportation, food, and housing.

The Robert Wood Johnson Foundation estimates social needs account for as much as 80% of health outcomes.2 If social needs are not met, physicians and other providers will be largely unable to improve outcomes. This is bad for patients, and makes it harder for physicians to succeed in value-based payment arrangements.3 Thus, identifying and addressing SDOH should be an integral part of family medicine practices.

But how do you have a meaningful conversation with your patient about SDOH during a 15-minute visit when other problems also need to be addressed? It starts with screening.