Leah Tuzzio1, Robert D Wellman2, Emilia H De Marchis3, Laura M Gottlieb3, Callie Walsh-Bailey4, Salene M W Jones5, Claudia L Nau6,7, John F Steiner8, Matthew P Banegas9, Adam L Sharp6,7, Alphonse Derus2, Cara C Lewis2. 1. Kaiser Permanente Washington Health Research Institute, Seattle, Washington Leah.tuzzio@kp.org. 2. Kaiser Permanente Washington Health Research Institute, Seattle, Washington. 3. University of California San Francisco, San Francisco, California. 4. Brown School, Washington University in St Louis, St Louis, Missouri. 5. Fred Hutchinson Cancer Research Center, Seattle, Washington. 6. Kaiser Permanente Southern California Research and Evaluation Department, Pasadena, California. 7. Kaiser Permanente School of Medicine Health Systems Science Department, Pasadena, California. 8. Kaiser Permanente Institute for Health Research, Denver, Colorado. 9. Kaiser Permanente Center for Health Research, Portland, Oregon.
Abstract
PURPOSE: Because social conditions such as food insecurity and housing instability shape health outcomes, health systems are increasingly screening for and addressing patients' social risks. This study documented the prevalence of social risks and examined the desire for assistance in addressing those risks in a US-based integrated delivery system. METHODS: A survey was administered to Kaiser Permanente members on subsidized exchange health insurance plans (2018-2019). The survey included questions about 4 domains of social risks, desire for help, and attitudes. We conducted a descriptive analysis and estimated multivariate modified Poisson regression models. RESULTS: Of 438 participants, 212 (48%) reported at least 1 social risk factor. Housing instability was the most common (70%) factor reported. Members with social risks reported more discomfort being screened for social risks (14.2% vs 5.4%; P = .002) than those without risks, although 90% of participants believed that health systems should assist in addressing social risks. Among those with 1-2 social risks, however, only 27% desired assistance. Non-Hispanic Black participants who reported a social risk were more than twice as likely to desire assistance compared with non-Hispanic White participants (adjusted relative risk [RR] 2.2; 95% CI, 1.3-3.8). CONCLUSIONS: Athough most survey participants believed health systems have a role in addressing social risks, a minority of those reporting a risk wanted assistance and reported more discomfort being screened for risk factors than those without risks. Health systems should work to increase the comfort of patients in reporting risks, explore how to successfully assist them when desired, and offer resources to address these risks outside the health care sector.VISUAL ABSTRACT.
PURPOSE: Because social conditions such as food insecurity and housing instability shape health outcomes, health systems are increasingly screening for and addressing patients' social risks. This study documented the prevalence of social risks and examined the desire for assistance in addressing those risks in a US-based integrated delivery system. METHODS: A survey was administered to Kaiser Permanente members on subsidized exchange health insurance plans (2018-2019). The survey included questions about 4 domains of social risks, desire for help, and attitudes. We conducted a descriptive analysis and estimated multivariate modified Poisson regression models. RESULTS: Of 438 participants, 212 (48%) reported at least 1 social risk factor. Housing instability was the most common (70%) factor reported. Members with social risks reported more discomfort being screened for social risks (14.2% vs 5.4%; P = .002) than those without risks, although 90% of participants believed that health systems should assist in addressing social risks. Among those with 1-2 social risks, however, only 27% desired assistance. Non-Hispanic Black participants who reported a social risk were more than twice as likely to desire assistance compared with non-Hispanic White participants (adjusted relative risk [RR] 2.2; 95% CI, 1.3-3.8). CONCLUSIONS: Athough most survey participants believed health systems have a role in addressing social risks, a minority of those reporting a risk wanted assistance and reported more discomfort being screened for risk factors than those without risks. Health systems should work to increase the comfort of patients in reporting risks, explore how to successfully assist them when desired, and offer resources to address these risks outside the health care sector.VISUAL ABSTRACT.
Authors: Emilia H De Marchis; Danielle Hessler; Caroline Fichtenberg; Eric W Fleegler; Amy G Huebschmann; Cheryl R Clark; Alicia J Cohen; Elena Byhoff; Mark J Ommerborn; Nancy Adler; Laura M Gottlieb Journal: JAMA Netw Open Date: 2020-10-01
Authors: Steven M Albert; Polly McCracken; Thuy Bui; Janel Hanmer; Gary S Fischer; Jaishree Hariharan; Alton Everette James Journal: BMC Health Serv Res Date: 2022-10-22 Impact factor: 2.908
Authors: Anna L Steeves-Reece; Christina Nicolaidis; Dawn M Richardson; Melissa Frangie; Katherin Gomez-Arboleda; Chrystal Barnes; Minnie Kang; Bruce Goldberg; Stephan R Lindner; Melinda M Davis Journal: Int J Environ Res Public Health Date: 2022-10-03 Impact factor: 4.614