Andermann Anne
1St Mary's Research Centre, McGill University, Montréal, Canada.
2Department of Family Medicine and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Canada.
Public Health Rev. 2018 Jun 22;39:19. doi: 10.1186/s40985-018-0094-7. eCollection 2018.
Screening for the social determinants of health in clinical practice is still widely debated.
A scoping review was used to (1) explore the various screening tools that are available to identify social risk, (2) examine the impact that screening for social determinants has on health and social outcomes, and (3) identify factors that promote the uptake of screening in routine clinical care.
Over the last two decades, a growing number of screening tools have been developed to help frontline health workers ask about the social determinants of health in clinical care. In addition to clinical practice guidelines that recommend screening for specific areas of social risk (e.g., violence in pregnancy), there is also a growing body of evidence exploring the use of screening or case finding for identifying multiple domains of social risk (e.g., poverty, food insecurity, violence, unemployment, and housing problems).
There is increasing traction within the medical field for improving social history taking and integrating more formal screening for social determinants of health within clinical practice. There is also a growing number of high-quality evidence-based reviews that identify interventions that are effective in promoting health equity at the individual patient level, and at broader community and structural levels.
在临床实践中对健康的社会决定因素进行筛查仍存在广泛争议。
采用范围综述来（1）探索可用于识别社会风险的各种筛查工具，（2）检查对社会决定因素进行筛查对健康和社会结果的影响，以及（3）确定促进在常规临床护理中采用筛查的因素。
在过去二十年中，已开发出越来越多的筛查工具，以帮助一线卫生工作者在临床护理中询问健康的社会决定因素。除了推荐针对特定社会风险领域（如孕期暴力）进行筛查的临床实践指南外，也有越来越多的证据探索使用筛查或病例发现来识别多个社会风险领域（如贫困、粮食不安全、暴力、失业和住房问题）。
在医学领域，改善社会病史采集并在临床实践中纳入对健康社会决定因素更正式的筛查的趋势日益明显。也有越来越多高质量的循证综述确定了在个体患者层面、更广泛的社区和结构层面有效促进健康公平的干预措施。
