Livingston Catherine J, Titus Tisha M, Yerokun Tobi A, Patel Neeti A
Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia.
Am J Prev Med. 2025 May;68(5):1041-1049. doi: 10.1016/j.amepre.2025.01.005. Epub 2025 Jan 9.
Interest is rapidly growing around screening for health-related social needs (HRSN) in direct patient care settings. The screening and provision of HRSN is often done in the context of trying to address social determinants of health. While there is emerging evidence that screening and referral for HRSN can improve health outcomes, there are educational, operational, and systemic gaps that need to be filled in order for HRSN screening and referral to be implemented system-wide and result in meaningful improvement in population health outcomes. The American College of Preventive Medicine recommends HRSN screening and referral in patient care settings only when there are sufficient systems in place to support addressing those needs. This paper identifies key considerations to take into account when implementing HRSN screening and referral in healthcare settings and makes recommendations to address those key considerations. The recommendations also frame the broader need to address social determinants of health at a population level. Finally, the paper identifies several knowledge and evidence gaps in the existing literature on the topic of HRSN, which will hopefully drive future research in this area, and result in an evidence-based, population approach to the issue.
在直接的患者护理环境中,对与健康相关的社会需求(HRSN)进行筛查的兴趣正在迅速增长。HRSN的筛查和提供通常是在试图解决健康的社会决定因素的背景下进行的。虽然有新的证据表明,HRSN的筛查和转诊可以改善健康结果,但为了使HRSN筛查和转诊在全系统得到实施并切实改善人群健康结果,还需要填补教育、操作和系统方面的空白。美国预防医学学院建议,只有在有足够的系统来支持满足这些需求时,才在患者护理环境中进行HRSN筛查和转诊。本文确定了在医疗保健环境中实施HRSN筛查和转诊时需要考虑的关键因素,并提出了解决这些关键因素的建议。这些建议还阐述了在人群层面解决健康的社会决定因素这一更广泛的需求。最后,本文指出了现有文献中关于HRSN主题的几个知识和证据空白,希望这将推动该领域未来的研究,并形成基于证据的人群方法来解决这一问题。