(HealthDay News) — From 2017 to 2022, there was an increase in social risk screening among U.S. physician practices, but only 27 percent of practices screened for all five social risks in 2022, according to a study published online Jan. 3 in JAMA Network Open.
Amanda L. Brewster, Ph.D., from the School of Public Health at the University of California in Berkeley, and colleagues examined trends in screening for five common social risks (food, housing, utilities, interpersonal violence, and transportation) among U.S. physician practices in an analysis using a nationally representative survey of physician practices, conducted in 2017 and 2022. A total of 3,442 practice survey responses were assessed.
The researchers found that 27 percent of practices reported screening for all five of the social risks in 2022, which marked an increase from 15 percent in 2017. A significant increase in the mean number of social risks screened per practice was seen in unadjusted results, from 1.71 to 2.34 in 2017 and 2022, respectively. Between 2017 and 2022, practice characteristics associated with screening for more social risks remained consistent and included being a federally qualified health center, having higher innovation culture scores, having higher advanced information system scores, and having higher payment reform exposure scores (incidence rate ratios, 1.550, 1.012, 1.003, and 1.002, respectively).
“As policies and programs that support social care integration into health care continue to be tested and disseminated, it will be important to examine how social risk screening, referral, and service delivery processes are associated with patient outcomes,” the authors write.
What is social risk screening?
Social risk screening in doctor’s offices involves systematically asking patients about their social circumstances that could impact their health. These circumstances, often referred to as Social Determinants of Health (SDOH), encompass a wide range of non-medical factors such as housing stability, food security, transportation access, financial strain, and social support. By identifying these risks, healthcare providers can better understand the challenges patients face and connect them with appropriate resources to improve their overall well-being.
Traditionally, healthcare has focused primarily on biological and medical factors. However, it’s increasingly recognized that social factors play a crucial role in health outcomes. For example, a patient with diabetes may struggle to manage their blood sugar if they lack access to healthy food or safe housing. Similarly, a patient with a chronic respiratory condition may experience more frequent exacerbations if they live in a home with mold or poor ventilation. Social risk screening aims to bridge this gap by incorporating social context into patient care.
What happens in social risk screening?
The screening process typically involves a brief questionnaire or a series of questions asked during a patient’s visit. These questions might cover areas such as:
- Housing: “Are you worried about losing your housing?” or “Do you have any problems with the physical condition of your housing?”
- Food Security: “Within the past 12 months, did you ever worry whether your food would run out before you got money to buy more?” or “Did you ever eat less than you felt you should because there wasn’t enough money for food?”
- Transportation: “Do you have reliable transportation to get to your medical appointments?”
- Financial Strain: “Are you having difficulty paying for basic necessities like food, housing, or utilities?”
- Social Support: “Do you have someone you can turn to for help if you have a problem?”
Once a patient’s social risks are identified, the healthcare team can take several steps to address them. This might include:
- Referrals to community resources: Connecting patients with local food banks, housing assistance programs, transportation services, or utility assistance programs.
- Care coordination: Collaborating with social workers or case managers to develop a comprehensive care plan that addresses both medical and social needs.
- Advocacy: Working with community organizations and policymakers to address systemic issues that contribute to social risks.
- Tailored medical advice: Adjusting treatment plans to account for a patient’s social circumstances. For example, a doctor might prescribe a less expensive medication if a patient is struggling financially.
Is social risk screening helpful for patients?
Social risk screening offers several benefits for patients:
- Improved health outcomes: By addressing social needs, healthcare providers can help patients better manage their health conditions and prevent future health problems.
- Enhanced patient-provider communication: Screening opens a dialogue about social challenges, fostering a more holistic understanding of the patient’s situation.
- Increased access to resources: Screening connects patients with valuable community resources that they might not otherwise know about.
- Reduced healthcare costs: By preventing costly hospitalizations and emergency room visits, addressing social risks can lead to significant cost savings for the healthcare system.
While social risk screening is a valuable tool, it’s essential to implement it thoughtfully. Healthcare providers need to be trained on how to conduct screenings sensitively and respectfully. They also need to have access to updated information on local resources and be prepared to follow up with patients to ensure they are connected with the support they need. In conclusion, social risk screening is a crucial step towards a more equitable and effective healthcare system that addresses the whole person, not just their medical conditions.