Showing posts with label social determinants of health. Show all posts
Showing posts with label social determinants of health. Show all posts

Friday, May 5, 2023

Social determinants of health and your patients

The topic of social determinants of health is receiving much attention lately, particularly in academic papers and consumer media. The question for doctors, however, is how do social determinants apply to the everyday practice of medicine?

According to the Centers for Disease Control and Prevention, social determinants of health are the conditions in which people live, learn, work, and play that can affect a wide range of health risks and outcomes. Everything from access to healthy food and housing to safe neighborhoods and education are considered social determinants and, in theory, can serve as predictors of-and factor into-population health.

In practice, however, social determinants take on a more real-world meaning. In a medical setting, they mean asking our patients some nontraditional-and sometimes difficult-questions.

Are you getting enough to eat? Do you feel safe at home? Do you feel lonely or isolated? These are just a few examples of the queries we should be posing to get a complete understanding of our patients’ medical history.

The good news is according to a survey from Leavitt Partners, more than 50 percent of physicians believe assisting patients with social determinants of health matters for wellbeing. The bad news is this research found the majority of physicians do not feel well-positioned to help address social determinants.

In addition, the majority of those surveyed do not believe doctors or insurance plans are responsible for providing that assistance, even though nearly half thought their patients would benefit from this type of assistance.

We physicians have a lot on our plates. But what if there were resources available to help patients without adding more to an already overworked schedule? By incorporating actions to help our patients who need it, we can make strides and enhance patient care and reduce traditional healthcare needs. For example, there are resources such as WellCare Health Plans’ free CommUnity Assistance Line (CAL) available to everyone in all 50 states, whether they have WellCare insurance or not. The call center fields more than 100,000 calls per year, connecting callers to local social services and programs that meet their needs.

And research shows programs such as these – ones that strengthen the social safety net – actually save money and improve outcomes, benefitting the health system and our patients. A recent study from the University of South Florida revealed a 10 percent reduction in healthcare costs for those who were connected to social services through WellCare’s CAL, which equates to nearly $2,500 per person annual savings. The findings provide additional evidence that social service programs can improve community health outcomes and reduce healthcare spending.

Taking on social determinants of health can feel daunting. But if we don’t address these issues, our patients can’t get to our offices, eat healthy foods, live in safe housing or meet their basic needs, which leads to, and magnifies, medical and behavioral health issues.

Tackling this issue isn’t solely a physician responsibility. It’s a collective one. But as a first step, we can help identify issues and refer patients to appropriate and available resources for support.


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Friday, June 3, 2022

Young people want their physicians to ask about social determinants of health

Young people want their primary care doctors to ask about social determinants of health (SDOHs) such as food and housing insecurity and discrimination, according to a new study.

The findings were based on a survey of more than 1,000 young people aged 14 to 24 who answered questions by text message in March 2021. The survey was part of the MyVoice National Poll of Youth, based in the University of Michigan’s Department of Family Medicine.

The poll inquired about housing, food, education, safety, and discrimination – and 81% of young people said their doctors and other health care staff should ask about those issues, according to a news release about the survey.

“It seems obvious that addressing social needs, like food and housing, in clinical settings would benefit patients. But we actually know very little about whether and how patients would want to receive this kind of assistance,” first author Claire Chang said in the news release. Chang is a U-M Medical School student.



“Youth in our study told us that they do want to talk about social determinants of health with their providers,” Claire Chang said. “It is important for us to understand these preferences and desires as social/medical care integration efforts spread across the country.”

In the survey, 30% said if they were experiencing difficulties with the SODHs, embarrassment might keep them from seeking help. Respondents said they would want physicians and health care staff to offer resources for people with social needs (25%) and referrals (13%), along with general advice (22%) and listening (11%), according to the study.

Respondents split on their preferences for receiving information, with 51% preferring to receive information or assistance in person, though they were amenable to telephone, email, and handouts.

The study, “Youth Perspectives on Their Medical Team’s Role in Screening for and Addressing Social Determinants of Health,” was published in the Journal of Adolescent Health.

An increasing number of health systems and clinics -- including U-M’s own academic medical center, Michigan Medicine -- now screen for SDOH’s as part of patient care, the researchers said in the news release.

“As a doctor, what I hear is my adolescent and young adult patients want me to ask them about more than their health. They want me to ask about their lives,” said Tammy Chang, MD, MPH, MS, poll director and U-M family physician. “This opens a door for doctors and other healthcare providers to really understand the root causes of the issues that young people are facing today. Youth in our study didn't expect providers to solve their issues, rather, just listen. I can do that.”


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