April 27, 2022, 9:43 a.m. News Staff — Results of a recent survey from The Physicians Foundation provide new insights on the degree to which social drivers of health affect not only patient health, but also physician practices and well-being. The survey found that while an overwhelming majority of physicians think these drivers, also known as social determinants of health, affect their patients’ health outcomes and that addressing them is essential to improving health outcomes and decreasing costs, significant barriers must be overcome for these issues to be properly addressed.
“We physicians know that reducing total cost of care and achieving health equity are only achievable by addressing the SDOH,” Physician Foundation President Gary Price, M.D., an attending surgeon and clinical assistant professor at Yale-New Haven Hospital in New Haven, Conn., told HealthLeaders. “We must remain central to this discourse and decision-making as we’re closest to these issues and our perspectives are critical to improving patient outcomes.
“But we cannot do it alone,” Price added. “Addressing SDOH requires a holistic approach, including comprehensive coordination among individual physicians, medical societies, health systems, social service systems and policymakers.”
The survey results closely mirror those of a 2017 Academy member survey that indicated more than half of family physicians already screened patients for SDOH and followed up by referring them to community-based social services — an important finding that illustrates family physicians have been aware of the significance of addressing SDOH for some time.
SDOH was thought prior to the COVID-19 pandemic to be responsible for as much as 80% of health outcomes. More recent research suggests that the social and economic disruptions caused by the pandemic have heightened the potential effects of SDOH on patient health and well-being even further.
The Physicians Foundation survey was conducted Feb. 3-11, 2022, by email to a list of U.S. physicians derived from Medscape’s database. It was designed to be completed in no more than 10 minutes, and consisted of 11 questions that addressed a wide range of SDOH topics.
A total of 1,502 physicians completed the survey, with 33% identified as practicing primary care (defined as family medicine, general practice, internal medicine or pediatrics). Most respondents were male (61%), white (63%), employed (67%) and between the ages of 36 and 65 (74%).
Of the physicians surveyed:
For substantial numbers of respondents, the inability to adequately address patients’ SDOH had negative effects on their practices and well-being.
Fortunately, the survey results also revealed a number of approaches to help.
When asked to rate the importance of nine strategies to support themselves and other physicians in addressing patients’ SDOH,
In a separate question on policy steps to improve outcomes and ensure cost-efficient, high-quality patient care,
The report stated that physicians recognize that SDOH and the health care system are linked in ways that cannot be easily separated. While most physicians want to effectively address their patients’ SDOH in the future, many feel constrained by barriers such as lack of time or inadequate resources, which is having a negative effect not only on patient health but physician well-being.
“To minimize SDOH’s effects on physician burnout and improve patient outcomes, change is needed,” the report said, pointing to several potential solutions and policy actions that health systems, payors and legislators could implement.
“As we continue building broad-based understanding of SDOH and their implications for patients and physicians, it is critical that physician and patient voices remain central to the discourse and decision-making,” the report concluded. “It is through addressing SDOH that we can improve patient outcomes for everyone and ensure that the physician workforce is well supported and financially recognized for its partnership with patients.”
Addressing SDOH to advance health equity has been a longstanding AAFP policy. In 2019, the Academy released a position paper that outlined the role family physicians can play in reducing health inequities by focusing on patient SDOH.
Several other resources are available as well. As part of the AAFP’s The EveryONE Project™, a four-part SDOH toolkit was developed to support members in addressing social needs in their practices and communities. Among other things, the toolkit includes a team-based approach guide for addressing SDOH, resources for social needs screening in English and other languages, implicit bias training guides, downloadable practice leadership slides on SDOH and a physician advocate brief with information on how to advocate for health equity and address SDOH.
In addition to these resources, the AAFP’s Neighborhood Navigator helps family physicians connect patients with local resources such as food, housing, finance and education.
The AAFP has also been active in recognizing the importance of SDOH on the advocacy front. In June 2021, the Academy sent a letter to Shalanda Young, acting director of the Office of Management and Budget, that commended the Biden administration’s commitment to advancing racial equity and that outlined the Academy’s “Health in All Policies” strategy as it relates to SDOH.
More recently, last November the Academy repeatedly referred to SDOH and addressing patients’ social needs as part of its response to HHS’ next five-year strategic plan. The AAFP also cited SDOH when calling for investments in public health infrastructure when advising Congress on preparing for the next pandemic in a letter to the chair and ranking member of the Senate Committee on Health, Education, Labor and Pensions in February.
Members can also access the latest information on the AAFP’s SDOH webpage, which is updated regularly.