TY - JOUR
T1 - Social Risks Among Primary Care Patients in a Large Urban Health System
AU - Heller, Caroline G.
AU - Parsons, Amanda S.
AU - Chambers, Earle C.
AU - Fiori, Kevin P.
AU - Rehm, Colin D.
N1 - Funding Information:
We would like to thank the leadership of Montefiore Medical Group, including the site-based leadership and champions who helped pilot and implement the screening tool. We would also like to thank Nicolette Guillou, Richard Reyf, Jacob Schutt, and Eva Franqui, who were instrumental in setting up the screening tool and providing social determinants of health reports. Dr. Chambers is supported by grants from the National Heart, Lung, and Blood Institute (K01HL125466 and 1R03HL140265). Dr. Chambers and Dr. Rehm are supported by a grant from the National Institutes of Diabetes and Digestive and Kidney Diseases (P30 DK111022). Dr. Fiori is supported by grants from the Doris Duke Charitable Foundation (2018169) and the Agency for Health care Research and Quality, HHS (K12HS026396). No other financial disclosures were reported by the authors of this paper.
Funding Information:
Dr. Chambers is supported by grants from the National Heart, Lung, and Blood Institute (K01HL125466 and 1R03HL140265). Dr. Chambers and Dr. Rehm are supported by a grant from the National Institutes of Diabetes and Digestive and Kidney Diseases (P30 DK111022). Dr. Fiori is supported by grants from the Doris Duke Charitable Foundation (2018169) and the Agency for Health care Research and Quality, HHS (K12HS026396).
Publisher Copyright:
© 2020
PY - 2020/4
Y1 - 2020/4
N2 - Introduction: Health systems are increasingly interested in addressing the social determinants of health via social risk screening. The objective of this study is to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. Methods: Between April and December 2018, a total of 24,633 primary care patients completed a 10-item screener across 19 ambulatory sites within a health system in the Bronx, NY. The prevalence of any social risk and specific social risks was estimated overall and for population subgroups. Wald tests were used to determine statistically significant differences by subgroup. Data were analyzed in winter/spring 2019. Results: Twenty percent of patients presented with at least 1 social risk. The most frequently reported risks included housing quality (6.5%) and food insecurity (6.1%). Middle-aged (30–59 years) respondents (24.7%, 95% CI=23.6%, 25.7%) compared with those aged 18–29 years (17.7%, 95% CI=16.4%, 19.2%, p<0.001), and Medicaid patients (24.8%, 95% CI=24.0%, 25.5%) compared with commercially insured patients (11.8%, 95% CI=11.1%, 12.5%, p<0.001), were more likely to report social risks. The strongest predictor of housing quality risk was residing in public housing (15.1%, 95% CI=13.8%, 16.6%) compared with those not in public housing (5.6%, 95% CI=5.3%, 5.9%, p<0.001). Housing quality was the most frequently reported risk for children (aged <18 years) and older adults (aged ≥70 years), whereas, for middle-aged respondents (30–69 years), it was food insecurity. Conclusions: There are important differences in the prevalence of overall and individual social risks by subgroup. These findings should be considered to inform clinical care and social risk screening and interventions.
AB - Introduction: Health systems are increasingly interested in addressing the social determinants of health via social risk screening. The objective of this study is to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. Methods: Between April and December 2018, a total of 24,633 primary care patients completed a 10-item screener across 19 ambulatory sites within a health system in the Bronx, NY. The prevalence of any social risk and specific social risks was estimated overall and for population subgroups. Wald tests were used to determine statistically significant differences by subgroup. Data were analyzed in winter/spring 2019. Results: Twenty percent of patients presented with at least 1 social risk. The most frequently reported risks included housing quality (6.5%) and food insecurity (6.1%). Middle-aged (30–59 years) respondents (24.7%, 95% CI=23.6%, 25.7%) compared with those aged 18–29 years (17.7%, 95% CI=16.4%, 19.2%, p<0.001), and Medicaid patients (24.8%, 95% CI=24.0%, 25.5%) compared with commercially insured patients (11.8%, 95% CI=11.1%, 12.5%, p<0.001), were more likely to report social risks. The strongest predictor of housing quality risk was residing in public housing (15.1%, 95% CI=13.8%, 16.6%) compared with those not in public housing (5.6%, 95% CI=5.3%, 5.9%, p<0.001). Housing quality was the most frequently reported risk for children (aged <18 years) and older adults (aged ≥70 years), whereas, for middle-aged respondents (30–69 years), it was food insecurity. Conclusions: There are important differences in the prevalence of overall and individual social risks by subgroup. These findings should be considered to inform clinical care and social risk screening and interventions.
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U2 - 10.1016/j.amepre.2019.11.011
DO - 10.1016/j.amepre.2019.11.011
M3 - Article
C2 - 32199514
AN - SCOPUS:85081123462
VL - 58
SP - 514
EP - 525
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
SN - 0749-3797
IS - 4
ER -