When patients struggle to get enough food, lack stable housing, or have limited access to transportation, their health can suffer. One analysis estimated that as much as 50 percent of the variation in health outcomes between counties in the U.S. can be attributed to social determinants of health like these. Such factors can limit the effectiveness of clinical care—but health care workers often don’t know what their patients are dealing with outside the clinic.

Addressing patients’ social needs is not always a priority in busy hospitals and clinics. But Andrea Wallace, PhD, RN, associate dean for research at the College of Nursing, has developed a way to make this a routine aspect of care. With systematic screening, patients’ unmet needs can be identified so clinicians can connect them with services that can help.

Wallace and her U or U Health colleagues have demonstrated that this screening can be done in emergency departments, which see disproportionate numbers of patients who are uninsured and have low incomes. The researchers are focused on finding the best ways to assess for social needs, considering factors such as language barriers, privacy concerns, and potential discomfort for patients and staff. In their most recent study, conducted at a children’s hospital in Salt Lake City, systematic screening allowed the team to identify 1,680 families with unmet social needs in a four-month period.

Wallace and colleagues have also shown how emergency departments can partner with a community service referral network to connect patients and families with services once needs have been identified. By helping secure access to healthy food, finding transportation to medical appointments, or assisting with rent and utilities, they can help patients get on a path to better health.

References:

Social Needs Screening During Pediatric Emergency Department Visits: Disparities in Unmet Social Needs. Tedford NJ, Keating EM, Ou Z, Holsti M, Wallace AS, Robison JA. Acad Pediatr. 2022 Nov-Dec;22(8):1318-1327. doi: 10.1016/j.acap.2022.05.002.

Integrating social determinants of health screening and referral during routine emergency department care: evaluation of reach and implementation challenges. Wallace AS, Luther BL, Sisler SM, Wong B, Guo JW. Implement Sci Commun. 2021 Oct 7;2(1):114. doi: 10.1186/s43058-021-00212-y.

Implementing a Social Determinants Screening and Referral Infrastructure During Routine Emergency Department Visits, Utah, 2017-2018. Wallace AS, Luther B, Guo JW, Wang CY, Sisler S, Wong B. Prev Chronic Dis. 2020 Jun 18;17:E45. doi: 10.5888/pcd17.190339.