Dr. Shelley Lynch has been passionate about public health for a very long time. On a trip to Jamaica during a collegiate trimester nursing program, she saw the delivery of a baby in a rural, poverty-stricken town. With no medical professionals on hand, the locals carried water and towels to the woman’s tin home. This life-changing experience was an early calling for Shelley’s focus on global public health, which eventually led to a Doctorate of Nursing Practice from UNC-Chapel Hill, where she studied Translational Science and the Social Determinants of Health.
Shelley’s latest public health efforts include a keynote address at her alma mater, UNC-Chapel Hill, on “The Extra One Degree: Lessons Learned from Building Partnerships in Global Health” and recently authoring a paper published in The Journal of Nurse Practitioners on “Social Determinants of Health Screening: Primary Care PRAPARE Tool Implementation.”
This project aimed to implement an evidence-based screening tool for Social Determinants of Health (SDOH) in a primary care practice over 12 weeks. Another objective was to provide referrals and resources for those who screened positive. In the study, evidence-based SDOH screening was implemented in a small urban primary care practice. This quality improvement project aimed to increase SDOH screening from 0% to 50%. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PREPARE) tool is a validated SDOH screener administered by a community health care worker during annual physical examinations over 12 weeks. PREPARE was administered to 81 of 85 patients (95.3%), and 8 (9.9%) screened positive. Benchmarks were surpassed for SDOH screening and resulted in referrals to community resources. Research should use community health care workers as care extenders and test SDOH screening to identify needs toward improved health.
Highlights of the paper include:
Patient’s social determinants of health (SDOH) are key drivers of health outcomes.
Beginning in 2023, accredited organizations are required to screen for SDOH.
We implemented validated SDOH screens in primary care, screening 95% of patients.
Implementing SDOH screening can lead to appropriate referrals and improved health
Health is impacted by where we live, where we play, and where we work. SDOH are the conditions in which people are born, grow, live, work, and age, and they encompass a wide range of factors that influence health outcomes. These determinants can significantly impact health in several ways:
Access to healthcare: SDOH can affect an individual's ability to access healthcare services, including primary care, preventive care, and specialty consultations. Income level, education, and geographic location can influence access to healthcare facilities and health insurance coverage.
Social and economic factors: Economic stability, employment opportunities, income level, and social support networks are critical determinants of health. Individuals facing economic hardship may struggle to afford healthy food, safe housing, transportation to medical appointments, and other essential resources, leading to poorer health outcomes.
Education: Education level is strongly linked to health outcomes. Higher levels of education are associated with better health behaviors, increased access to healthcare, and improved overall health status. Education provides individuals with the knowledge and skills to make informed decisions about their health and access available resources.
Environmental factors: The physical environment in which individuals live, work, and play can significantly impact health. Exposure to environmental hazards such as air and water pollution, toxins, and unsafe living conditions can increase the risk of chronic diseases, respiratory problems, and other health issues.
Social support networks: Strong social support networks, including relationships with family, friends, and communities, are protective factors for health. Social isolation and lack of social support have been linked to poor mental health outcomes, increased stress levels, and higher rates of chronic diseases.
Behavioral factors: SDOH influences health-related behaviors such as diet, exercise, smoking, and substance abuse. Individuals with limited access to healthy food options or safe recreational spaces may be at higher risk for obesity, cardiovascular disease, and other chronic conditions.
Stress and discrimination: Social determinants such as discrimination, racism, and socioeconomic inequality can contribute to chronic stress, which has been linked to a range of adverse health outcomes, including hypertension, cardiovascular disease, depression, and anxiety.
If healthcare providers strive to improve health, we need to focus on the social determinants of health. To improve the social determinants of health, we need to start with screening for them during office or hospital visits and provide a link from patients to community services to help improve the social determinants.
ACLS Academy is an authorized American Heart Association (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.