Screening for Social Determinants of Health in Primary Care

A pediatrician is smiling and engaging with her patient. A toddler-aged patient is seated and shown smiling at the camera.

There’s increasing consensus that health care providers can improve children’s lives by paying attention to social determinants of health, or what are sometimes called health-related social needs. Food security, stable housing and similar concerns can make a big difference to child well-being.

But many health care providers aren’t screening families for these needs. Beyond that, there are no standardized methods for performing those screenings, or connecting families to important resources if they need help.

A recent study from Nationwide Children’s Hospital examined the hospital’s efforts to improve screening through electronic medical records, to keep screening levels high once they were improved, and to connect families to help they needed.

Among many other findings, researchers discovered that nearly 10% of families screened did have at least one social need, 3% had an urgent need (like the lack of safe place to sleep), and the hospital was able to complete social work consultations with 85% of families in need within seven days.

The lessons learned are helping Nationwide Children’s now, and may help other hospitals in the future, says Millie Dolce, PhD, MSW, program evaluator analyst for wellness initiatives at Nationwide Children’s Hospital and lead author of the study.

“How can we optimize the screening and referral process so that we can move the needle? That requires other larger hospitals who may be doing this to set some benchmarking goals and collect baseline data on the larger community metrics,” Dr. Dolce says. “If we can improve patients’ housing, nutrition and utilities, will we see increased high school graduation rates, improve kindergarten readiness and have a workforce making a livable wage?”