by 
Share On Social!
Where you live can have a big impact on your health.
Non-medical factors like where we are born, live, work, and age — known as social determinants of health (SDoH) — can influence health for better or worse.
However, the U.S. has struggled to identify and help people with SDoH issues.
That’s where SDoH screening comes in.
SDoH screening is a questionnaire given to patients in a healthcare setting to help providers identify non-medical barriers to health. These include issues like financial hardship, transportation, housing, food, employment, and safety.
Patients can then be referred to helpful community resources.
Here are seven reasons to implement SDoH screening in your healthcare system, hospital, or clinic.
1. SDoH Screening Helps Patients Speak Up
SDoH screening provides a flexible, low-barrier method for patients to provide information about non-medical factors that impact their health.
Healthcare staff can conduct screening electronically, in writing, or verbally.
A systematic review of 21 SDoH screening tools in 2018 found that the majority were administered by paper (n=11, 52.4%), followed by verbally (n=9, 42.9%) and electronically (n=7, 33.3%).
However, since this review, many electronic health record systems have included an SDoH screening tool, thus much more screenings are being done electronically.
2. SDoH Screening Helps Clinicians Better Understand Patients
SDoH screening can help clinicians better understand patients’ immediate social needs.
This gives them insight into the lived experiences of their patients which is crucial for clinicians to develop meaningful medical and behavioral treatment plans.
Sensitivity is important because meaningful medical and behavioral treatment plans can improve medical care, reduce hospital readmissions, and reduce healthcare costs.
3. SDoH Screening Helps Clinicians Address Patients’ Needs
SDoH screening can help clinicians and non-clinicians address patients’ immediate social needs.
This, again, gives them insight into the lived experiences of their patients, which is crucial for clinicians and non-clinicians to connect patients to relevant community resources.
For example, organizations using the PRAPARE® SDoH screening tool “negotiated bulk discounts for taxi vouchers and bus tokens for patients in need of transportation,” and “partnered with Uber, Lyft, and other ride-sharing services to provide discounted transportation services for patients in need,” according to the PRAPARE® Implementation and Action Toolkit.
This is important because connecting patients to community resources can reduce social needs that threaten health thus improving overall health, which reduces hospital re-admissions and healthcare costs.
4. SDoH Screening Helps Foster Community Collaboration
A successful SDoH screening program does more than gather information from patients.
Screening programs must establish connections with community-based organizations that can help address patients’ social needs.
Food banks, homeless shelters, and transportation agencies are important. Likewise, local gyms, faith-based organizations, and community centers provide additional opportunity for collaboration.
You may establish a team to connect with community-based organizations.
“Many healthcare organizations lack a formal inventory of a community’s available resources to address SDoH, as well as a standard process for tracking what happens after [SDoH screening] referrals,” according to the Center for Health Care Strategies (CHCS). “Often there is a lack of coordination between a community’s social service organizations and healthcare providers, many of which serve the same clients.”
5. SDoH Screening Helps Healthcare Assessment, Management
SDoH screening can support hospital system performance management and recommendations to inform policy and payment in several areas.
Areas include process-of-care, efficiency, safety, costs, health care outcomes, and patient satisfaction.
“The expansion of value-based payment programs exacerbates concerns about the adverse effects of social risk factors on provider payment,” according to eight researchers across the country.
“Hospitals, clinicians, and other providers with the fewest resources often serve the most vulnerable people. Without appropriate risk adjustment, these providers are most likely to be penalized.”
6. SDoH Screening Can Increase Advocacy for Addressing ‘Root Causes’
SDoH screening can support understanding about social risk factors thus support advocacy for upstream strategies to address the root causes of health inequities.
Some people face health barriers because of structural and systemic policies. These policies curb their access to quality housing, transportation, food, jobs, schools, parks and other social determinants.
Individuals have no choice when it comes to these structural health barriers.
“Despite the tremendous, lifelong impact of our community conditions on our health, we focus most of our energy and resources on treating the outcomes of these problems but lack the essential urgency for attacking the root causes of poor health,” according to Brian C. Castrucci, Dr. Johnathan Fielding, and John Auerbach.
7. SDoH Screening Can Improve Health Equity in the Healthcare System
Through SDoH screening, adjusting for social risk avoids worsening inequities in healthcare, according to eight researchers.
“Inequities in the health care system and society at large have become a stain on the United States, and resources should not be taken away from those who care for the most vulnerable. The highest priority for physicians is to ‘first, do no harm.’ We should ask no less of performance measurement.”
Create an SDoH Screening Tool in Your Healthcare Setting!
In summary, SDoH screening can help healthcare better understand and address patients’ needs.
It can also aid in healthcare performance assessment, advocating for upstream change, and reducing health inequities.
So, how can you start?
Salud America! at UT Health San Antonio is spotlighting examples of SDoH screening in action:
Salud America! also has showcased two lists of SDoH screening tools:
“Health is far more than what can be provided in a doctor’s office,” said Dr. Amelie Ramirez, director of Salud America!. “In the same way that a team of doctors develops a patient treatment plan to treat cancer, a team of doctors and community services should develop a patient treatment plan that includes addressing social needs and their root causes.”
By The Numbers
33
percent
of Latinos live within walking distance (<1 mile) of a park
