PCORI Evidence Map: Social needs interventions to improve health outcomes: Scoping review and evidence map update

We previously reported on interventions addressing social determinants of health and health outcomes in August 2021 and published an evidence map allowing interactive visualization of intervention characteristics for this evidence base.

This report summarizes the results of an updated search, last conducted on November 29, 2021 (November 2021 data update). The search yielded 19 additional studies (in 23 publications), for a cumulative total of 157 studies (in 178 publications). In reviewing patterns and trends in the evidence, we noted that nearly half (47%) of eligible studies (N = 157) were published in the past 6 years (2016-2021). As research accumulates, the total number of randomized controlled trials (RCTs) has increased over time, but observational single-arm studies have become a larger proportion of the evidence base. RCTs and single-arm studies each comprise 31% of all 157 studies, while 29% are cohort studies with comparison groups, and 10% are comparative effectiveness studies. Included studies most commonly cited health care services access and quality (n = 113 studies) as well as housing stability and quality (n = 95 studies) as social needs addressed. Forty-nine studies included majority black populations, and 20 included majority Hispanic or Latino populations. No single group was a majority in 38 studies. More than three-quarters of studies (n = 124) focused on adults (aged ≥18 years). Health care utilization outcomes were most commonly reported and included resource-intensive events such as emergency department visits and inpatient admissions. Most studies reported positive (ie, results consistent with the study’s intended direction of effect), mixed (ie, inconsistent results across multiple but similar outcomes), or no effects; a minority reported negative outcomes (ie, results favoring the comparison arm). More commonly reported outcomes were more likely to present a mixed picture or no effects, whereas less commonly reported outcomes generally favored the intervention. 

See previous report here and accompanying PCORI Evidence Map here.