The feasibility of screening for social determinants of health: Seven lessons learned

Social determinants of health” (SDOH) has become an inescapable buzzword in family medicine in part because of the magnitude of impact that SDOH have on our patients' wellbeing. Drawing a direct comparison between social factors and medical conditions, researchers have estimated that low education, racial segregation, and low social support make a contribution to mortality that is equivalent to acute myocardial infarction, cerebrovascular disease, and lung cancer, respectively. Particularly as we strive toward the Quadruple Aim in health care, the “conditions in which people are born, grow, live, work, and age” can no longer be categorized strictly as nonmedical factors and, therefore, outside the scope of primary care.

Although many in primary care agree about the importance of screening patients for social needs and referring to supportive community resources, legitimate concerns exist about the feasibility of doing so. To explore these issues, our family medicine clinic recently conducted a nine-month SDOH pilot project. This article shares our outcomes and some surprising lessons learned.