Opening doors to health equity: Screening for social determinants of health at community health fairs

Introduction: Social determinants of health (SDOH) encompass factors that can significantly impact an individual's health and well-being. Overlooking these determinants can contribute to health disparities and inequitable distribution of health care opportunities. Recognizing this, Healthy People 2030 prioritizes addressing SDOH by promoting social, physical, and economic conditions that support optimal health for all. Schools of pharmacy can help bridge health equity gaps in their communities by incorporating SDOH screenings into health fairs. 

Objectives: This study describes the development and implementation of a SDOH screening tool within School of Pharmacy health fairs to identify needs related to care access, chronic disease prevention and management, nutrition, physical activity, food security, and transportation. A secondary study objective was to examine identified needs and referral patterns to address those needs. 

Methods: The University of the Pacific's School of Pharmacy developed and implemented a SDOH screening tool at health fairs in underserved communities in South Stockton, where the prevalence of diabetes and prediabetes was 60% or more. The screening assessed challenges related to food security, access to healthy foods and nutrition education, non-emergency medical transportation, health insurance, and diabetes prevention or management resources. Based on the results, referrals to local social service agencies were submitted online. 

Results: Between 2022 and 2023, the SDOH screening tool was utilized at 14 health fairs. Among 1327 patients served, 574 unique individuals completed the screening, generating 751 referrals to social service agencies. The referrals included 35.8% (n = 269) for nutrition education, 18.5% (n = 139) for emergency food assistance, 17.0% (n = 128) for a diabetes prevention program, 10.9% (n = 82) for diabetes education through community health workers, 9.5% (n = 71) for safety net clinics, and 8.3% (n = 62) for non-emergency medical transportation. 

Conclusion: Integrating SDOH screening into pharmacy school outreach events can enhance their impact by identifying individuals in need and connecting them with essential social services, supporting community well-being.