The Rise of Screening for Social Determinants of Health


SDoH screening
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Did you know that your Zip code is more important than your genetic code in predicting how long you will live?

That’s right – where you live can have a big impact on your health.

In fact, our health is influenced by a variety of non-medical factors, such as the conditions in which we are born, grow, live, work, and age. These conditions are known as social determinants of health (SDoH).

Addressing SDoH is key to improving health for Latinos and all people. Numerous studies suggest that SDoH accounts for between 30-55% of health outcomes and SDoH influences individual health behaviors, which account for another 30% of health outcomes.

Fortunately, healthcare systems are placing more emphasis on screening patients for SDoH.

This means that when patients come to medical appointments, they may be asked a series of questions or to fill out a questionnaire that can help healthcare providers identify non-medical barriers to health, such as lack of options to obtain healthy food, lack of transportation to maintain employment, or lack of access to affordable medication.

We at Salud America! at UT Health San Antonio are spotlighting why screening for SDoH is so important, especially among Latinos, and how screening can help improve health outcomes.

SDoH and Latinos

Latinos face a variety of social, environmental, and economic inequities in their neighborhoods and communities that create social need and negatively impact health. These include low wages and limited employee benefits; underperforming schools; lack of medical providers; unstable and unaffordable housing; low access to nutritious food; unreliable transportation options; and unsafe streets and parks.SDoH graph

These inequities are the root causes of Latino health disparities, such as higher rates of obesity and diabetes, certain cancers, and infectious diseases like COVID-19.

Because these inequities stem from decades of systemic policies that concentrate poverty and disadvantage Latinos and other people of color, we must shift from individualist thinking to structuralist thinking to improve health equity.

One step in that direction is SDoH screening among medical providers.

The Need for SDoH Screening

While going to the doctor is certainly good for one’s health, traditional medical care does not account for the social needs that arise from health inequities in our Zip codes.

SDoH screening can help medical providers better understand those social needs and their root causes.

An SDoH screening tool is a questionnaire that gathers information from patients about their general social needs in addition to their immediate health needs.

When patients are screened for social needs at their medical appointments, healthcare providers can identify ways to address those needs and their root causes.

“Health systems can benefit by understanding the social determinants in the communities in which their patients live,” according to the Agency for Healthcare Research and Quality. “In addition to giving them insights into the lived experiences of their patients, health systems that learn about the SDoH of the communities they serve may become inspired to engage in community-level efforts to address those SDoH, such as establishing farmers markets in food deserts, safe exercise space, or affordable housing.”

In this way, SDoH screening has the power to identify and address the causes of social needs which can dramatically change patient health outcomes.

Take ThedaCare’s community paramedicine program, for example.

ThedaCare, a nonprofit health system in Wisconsin, created the program to address social needs among patients who frequently visit the emergency room and are identified as needing additional health services.

As part of the program, paramedics use an SDoH electronic screening tool to identify and provide at-home services to patients in need.

The screening tool prompts paramedics to ask patients about barriers to healthcare or environmental hazards that may be present in their home.

For one patient, who experienced up to 30 seizures a day, ThedaCare’s paramedics identified two social needs: a lack of air conditioning, which aggravated his condition, and poor medication management.

ThedaCare paramedics addressed the social needs that contributed to this patient’s poor health by helping manage his medications and connecting him to community air conditioning services.

As a result, the patient stopped having seizures and was able to resume normal activities in his community.

In addition to the community paramedic program, ThedaCare has also created a community health plan and a community advisory board to address systemic issues that contribute to poor health.

Through these actions, ThedaCare can address both social needs and the causes of those needs.

An Essential Tool in Healthcare

SDoH screening has the power to address a variety of health-related social needs for Latinos and all people.

“Health is far more than what can be provided in a doctor’s office,” said Dr. Amelie Ramirez, director of Salud America! and its home base, the Institute for Health Promotion Research at UT Health San Antonio. “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.”

You can help promote SDoH screening and health equity, too.

Select your county and get a Health Equity Report Card by Salud America! at UT Health San Antonio.

In your report card, you will see maps, data, and gauges to compare public health issues to the rest of your state and nation.

You can email your Health Equity Report Card to local leaders to stimulate community change. Use the data in your materials or share on social media to raise awareness about the importance of SDoH screening.

Get your Health Equity Report Card!

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