In a significant effort to better understand and address social determinants of health (SDoH), a health system conducted extensive assessments between January 2020 and April 2023. The study aimed to investigate the correlation between self-reported SDoH needs and area-level social vulnerability using the Social Vulnerability Index (SVI). Utilizing diverse modalities such as telephonic outreach, in-person clinical interactions, and digital platforms, the study gathered data from both health plan members and nonmembers.
Study Design and Participants
This cross-sectional study included 841,874 assessments from 401,697 individuals, with a median age of 55 years and a gender distribution of 55.1% women. Participants were identified through various means, including telephonic outreach, face-to-face interactions, and web-based tools. The respondents included both members of the Highmark Health Plan and nonmembers, who participated during inpatient or outpatient encounters with the affiliated health system.
Main Findings
The study identified SDoH needs in 120,769 assessments, representing 14.3% of the total. A noteworthy finding was the increasing association between higher SVI and the rate of identified SDoH needs. For instance, 11.2% of individuals in the lowest-risk SVI quintile reported needs, compared to 22.7% in the highest-risk quintile. The odds of positive screening for SDoH needs were significantly higher for those in the highest-risk quintile, with adjusted odds ratios ranging from 1.74 to 3.73.
Concrete Inferences
Key takeaways from the study include:
- Telephonic and digital outreach methods can effectively identify SDoH needs across diverse populations.
- Higher social vulnerability is strongly linked with increased reporting of SDoH needs, underscoring the necessity for targeted interventions.
- Even in high-risk areas, only about 25% of individuals reported SDoH needs, indicating potential underreporting or barriers to self-disclosure.
These insights highlight the critical role of individual-level SDoH data in planning and delivering tailored health services. Despite the clear correlation between area-level social vulnerability and reported needs, individual assessments remain crucial for effective resource allocation and intervention strategies.
Original Article: JAMA Netw Open. 2024 May 1;7(5):e2412109. doi: 10.1001/jamanetworkopen.2024.12109.
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