Screening for Social Determinants of Health

By: Paul Dworkin, MD

It’s important that physicians screen for problems related to the critical social determinants of health. Those are the circumstances in which people live and work, such as food insecurity, housing insecurity, and transportation, that have been shown to have twice the impact on overall health outcomes compared to the medical care people receive.

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We are seeing progress in this area. However, much more needs to be done.

I co-authored a viewpoint piece on this topic, along with Arvin Garg, MD, MPH, and Renee Boynton-Jarrett, MD, ScD, both of Boston University School of Medicine, which was just published online in JAMA, The Journal of the American Medical Association.

In the piece, we not only urge additional screening opportunities for the social determinants of health, but we also stress that four key principles should be applied to ensure the benefits of such screening and minimize unintended consequences.

Those principles are:

  1. Social determinants screening should be patient- and family-centered involving shared decision making;
  2. It should be conducted within a comprehensive process and system supporting early detection, referral, and linkage to community-based services;
  3. It should engage the entire practice population rather than targeted subgroups; and
  4. It should acknowledge and build on the strengths of patients, families, and communities.

By utilizing the above mentioned principles to enhance screening for social determinants of health, we have huge potential to enhance the optimal healthy development of children.