More on Population Health

Screenings for social determinants of health need to be tailored to clinics, BU finds

The average health center only screened for 8 of the 16 domains in the pilot's standardized screening.

Jeff Lagasse, Associate Editor

An estimated 70 percent of the variation in healthcare outcomes is attributable to social determinants -- but it is only in recent years that healthcare settings have begun formally looking at these factors to better understand and treat patients.

A new study co-authored by Boston University School of Public Health researchers and published in the Journal of the American Board of Family Medicine finds that these social determinant screening systems need to be tailored to individual clinics.


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Among clinics, there wasn't much agreement about whether various factors -- workflow, provider perspectives, prior experiences, site resources and staffing -- were impediments of facilitators for implementing the screening. Some thought they were barriers. Others disagreed.

For the mixed-methods study, the researchers looked at the social-risk screening practices at 13 Center for Community Health Education Research and Service Boston community health centers. They analyzed all of the screening materials from the 13 centers, and conducted focus groups with nine physicians, three nurses and 14 medical assistants from three centers that had participated in a pilot screening and referral program.

They found that, while all of the community health centers were screening for social determinants, they were not all screening for the same ones, or screening for the same determinants in their adult patients and in pediatric patients.

The average health center only screened for 8 of the 16 domains in the pilot's standardized screening, and housing was the only domain included in the screenings of all 13 centers.

The authors noted that perspectives in the focus groups mostly differed from center to center, rather than between providers and staff.


In April, UnitedHealthcare and the American Medical Association announced they had entered into a collaboration that will better identify and address social determinants of health with the goal of improving access to care and patient outcomes.

Building on work initiated by UnitedHealthcare, the two organizations are working together to standardize how data is collected, processed and integrated regarding critical social and environmental factors that contribute to patient well-being.

Twitter: @JELagasse

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