A practical approach to screening for social determinants of health

Decades ago, the historic Whitehall studies demonstrated the impact that social context can have on individuals' health and wellbeing. Family physicians understand this well because they see firsthand how social needs (or “social determinants of health”) create access, adherence, or performance barriers, often impeding their efforts to provide evidence-based clinical care that improves overall health. For example, a patient who lacks safe housing, reliable transportation, or adequate food resources may struggle with medication adherence or getting to visits on time.

The ecology of medical care and the current financing system, which tend to focus on health care as opposed to health, may limit physicians' ability to address social context. Nevertheless, family physicians can take practical steps to address social determinants of health in their practices. This article will discuss the concerns and challenges related to screening for social determinants of health and offer several tools and recommendations.