National data on social risk screening underscore the need for implementation research

Social risk screening and documentation in medical settings are recommended by several national medical professional organizations. These recommendations are based on the increasingly compelling evidence that social risks are associated with poorer treatment adherence, worse health outcomes, and greater costs of care. Systematic screening for patients’ social risks is a key component of providing the data needed to address critical knowledge gaps regarding the role of the health care delivery system in mitigating these detrimental outcomes. But to what extent is social risk screening conducted in clinical settings?

Fraze et al analyzed data from the 2017-2018 National Survey of Healthcare Organizations and Systems to estimate the prevalence of screening for 5 social risks—food insecurity, housing instability, utility needs, transportation needs, and the occurrence of interpersonal violence—in physician practices and hospitals. The authors also examine organizational characteristics associated with adoption of screening for these risks. According to the responses studied, their results suggest that such screening occurs in a minority of practices and that certain practice characteristics—notably engagement in bundled payment or primary care improvement models—are associated with higher rates of screening adoption.