Finances and employment domains are strong determinants when screening for unmet social needs in a predoctoral dental clinic: A preliminary assessment

INTRODUCTION: Recent efforts by advocates and policy makers have articulated the importance of gaining a deeper understanding of determinants of health to improve health outcomes and reduce health disparities. Social determinants of health (SDOH) are routinely taught in oral health professions curriculum; however, there are limited studies assessing clinical implications. The purpose of this study was to assess the prevalence of SDOH in dental school clinics and associations with socioeconomic and demographic data and health literacy (HL). 

METHODS: Predoctoral clinical patients were surveyed using a 28-item, using Likert scale, multiple choice, open text, and binary yes/no items. Associations between unmet social needs (USNs) and gender, age, race/ethnicity, annual household income, zip code, and HL were evaluated. The data were descriptively and statistically analyzed (p-values < 0.05). 

RESULTS: There were 204 respondents, males (48%) and females (50%), with 2% non-binary reporting 331 USN cumulatively and 76% reporting one or more USN. The greatest domains were employment (27.5%), finance (23.0%), food (27.5%), and transportation (18.6%), with significant associations for employment (p < 0.0001), finance (p < 0.0001), food (p < 0.0001), and transportation (p < 0.0001). A total of 80.79% of the respondents had adequate HL, and individuals with zero and one USN had higher mean HL score versus three USNs (p = 0.0014 and 0.041, respectively). 

CONCLUSION: Screening for USNs in dental clinics is an excellent method to gather non-medical information that can be used to improve health outcomes. Within the limits of this study dental clinic patients have unmet need across the SDOH domains, with the highest in finance, employment, transportation, and food insecurities.