Assessing Social Determinants of Health in West Chicago Community Clinics

A growing body of evidence shows the impact of social determinants on health status, especially among underserved populations.  The primary aim of this study was to conduct a needs assessment to identify the prevalence of specific social determinants of health (SDOH) in four urban community residency clinics.  A secondary aim was to identify patient-desired interventions to address areas of need.  Eight social determinants were chosen based on current literature and physician experience. A 42-item questionnaire was administered at the four clinic sites.  Eligible patients were 18 years and older and all data were collected via self-report. A single question was selected as an indicator to capture the prevalence of each SDOH.  Statistical tests were computed using Stata version 13.  Patient survey responses indicated the following prevalence rates for the eight SDOH assessed: lack of education (41%), financial insecurity (31%), substance use (30%), mental and physical abuse (28%), lack of transportation (23%), lack of social support (15%), food insecurity (9%), and housing insecurity (6%).  Notably, 41% were burdened by ≥2 SDOH.  Consistent themes in patient-desired interventions included printed health literature and financial resources such as bus vouchers and discounted medications. These results will inform efforts to mitigate the potential detrimental effects of social determinants on health status in this patient population.  A better understanding of social determinants and patient-preferred interventions among primary care providers is critical for optimally addressing the multi-faceted needs of patients.