More physicians are screening patients for social risks

More physicians are screening patients for potential risks among social drivers of health.

However, the number of doctors doing so still is far from a majority, according to data in a new study that examined trends from 2017 to 2022.

“Social risk screening increased substantially” during that period, but was less than one-third of all practices, according to “Trends in Screening for Social Risk in U.S. Physician Practices,” published in JAMA Network Open.

In recent years there has been increased attention about the role of physicians, and the health care system overall, in assisting patients with at least five common social risks: food, housing, utilities, interpersonal violence, and transportation. But there are many unanswered questions about how physicians gather the data and whether screening leads to better patient outcomes, according to the study and an accompanying commentary on it.

“What remains to be seen is whether practices use these data to help improve patient health by adjusting health care or referring patients for assistance with social needs,” the study said. “As policies and incentives increasingly emphasize social risk screening, it will be important to assess the association of screening and referrals with patient outcomes.”

By the numbers

Medical practices screening for all five social risks increased from 15% in 2017 to 27% in 2022, according to the study, while practices screening for any grew from 67% to 74%. The results were based on responses from the National Survey of Healthcare Organizations and Systems.

For individual risks, screenings all rose from 2017 to 2022:

• Food insecurity, from 29% to 47%
• Housing instability, from 28% to 44%
• Utility needs, from 23% to 34%
• Transportation needs, from 35% to 47%
• Interpersonal violence, from 56% to 61%

The figures were unadjusted results.

Doctors, patients and social risk

The authors noted the results suggest medical “practices nationwide are changing their processes of care to more systematically consider patients’ social circumstances.” In the last five years, that change in care has been recommended by leading health care institutions and was a pillar of President Joe Biden and his administration’s “Playbook to Address Social Determinants of Health,” the study said.

“Screening for social risks does not necessarily imply that practices are using the information to either adjust care or provide referrals to address social needs, but it is normally the first step toward doing so,” the study said. “The increase in social risk screening suggests that U.S. physician practices have become better positioned to recognize and potentially address unmet social needs in vulnerable patient populations.”

That includes primary care – the researchers found social risk screening was not limited to practices serving patients with lower incomes.

Unanswered questions

Valerie G. Press, MD, MPH, and Joyce W. Tang, MD, MPH, evaluated the study in their commentary, “Social Risk Screening Is Increasing, but Is Screening Enough?” also published in JAMA Network Open.

The field is ripe for additional research such as development of uniform and effective approaches to screening. Asking patients about social risk factors does not always match their goals and priorities relating to social needs, they said. The study authors acknowledged they could not identify whether screening led to actual interventions to address unmet social needs.

“Given that the lack of screening uptake is in part due to concerns about not having sufficient resources to address identified risks, it will be important for future studies to evaluate the effectiveness of screening on health outcomes,” the commentary said.