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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 313 Research Studies Displayed
Blanco C, Kato EU, Aklin WM
AHRQ Author: Kato EU, Tong ST, Bierman A, Meyers D
Research to move policy - using evidence to advance health equity for substance use disorders.
This paper discusses ways that evidence-based research can advance health equity for substance use disorder (SUD) treatment. Racial and ethnic disparities in treatment access and outcomes have widened, despite substantial efforts to address the epidemic of overdose-related deaths in the US. Overdose rates are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in White populations. Possible opportunities to address these disparities include addressing social determinants of health, implementing prevention measures, and supporting data science. The steps to ensure that research reduces disparities are to: 1) include members of underrepresented groups in the development of preventive interventions and treatments, 2) adequately recruit members of historically represented groups and ensure that studies are large enough to measure differences in outcomes according to race and ethnic group, 3) establish equitable partnerships with people who currently have or have had SUDS and their families and engage these groups in evidence production, 4) diversify the scientific workforce, and 4) have investigators measure the effects of policies and interventions on equity.
Citation: Blanco C, Kato EU, Aklin WM . Research to move policy - using evidence to advance health equity for substance use disorders. N Engl J Med 2022 Jun 16;386(24):2253-55. doi: 10.1056/NEJMp2202740..
Keywords: Substance Abuse, Behavioral Health, Policy, Racial / Ethnic Minorities, Disparities, Social Determinants of Health
Kostelanetz S, Pettapiece-Phillips M, Weems J
Health care professionals' perspectives on universal screening of social determinants of health: a mixed-methods study.
The purpose of this AHRQ-funded study was to assess health care providers’ perceptions of universal social determinants of health (SDH) screening. Th researchers used mixed methods of electronic surveys and qualitative interviews to assess health care providers (physicians, administrators, advanced practice providers, nurses, pharmacists, social workers, and case managers) on their perceptions of universal SDH screening at an academic medical center. The electronic survey evaluated SDH screening practices, attitudes and barriers to universal screening, priorities for SDH domains, and disciplines to perform screening. There were 193 survey participants, representing a 62.5% response rate, most of which were physicians (31%) or social workers (22%). Ninety-three percent of respondents reported using SDH information in patient care, with 95% reporting that social workers were the most appropriate for providing screening. Barriers to SDH screening which were identified included lacking the: resources to address the needs which were identified (51%); time to ask (45%); staff to ask (33%) and; training in responding to the identified needs (28%). Social worker staff reported barriers less frequently than non- social worker staff. The qualitative interview (n=16) results were utilized to elaborate the electronic survey findings and identify themes. Qualitative interview data supported the survey findings and described barriers such as lack of standardized approaches and professional burnout. The researchers concluded that health care providers support universal social determinants of health screening and recommend that strategies to address barriers to implementation should include improving SDH data access for providers and capitalize on social worker expertise.
Citation: Kostelanetz S, Pettapiece-Phillips M, Weems J . Health care professionals' perspectives on universal screening of social determinants of health: a mixed-methods study. Popul Health Manag 2022 Jun;25(3):367-74. doi: 10.1089/pop.2021.0176..
Keywords: Social Determinants of Health, Screening, Provider: Health Personnel
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
Citation: McQueen A, Kreuter MW, Herrick CJ . Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes. Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords: Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Cole MB, Nguyen KH, Byhoff E, Byhoff E
Screening for social risk at federally qualified health centers: a national study.
In the United States, millions of low-income patients have unaddressed social risks. Federally Qualified Health Centers (FQHCs) provide services to approximately 29.8 million low-income patients, and data on social risk screening capabilities had never been collected across all FQHCs until 2019. The purpose of this study was to analyze the social risk screening capabilities across the FQHCs, report the national rates, identify screening predictors, and compare rates between states. The researchers collected data from the 2019 Uniform Data System from all 1,384 FQHCs across the U.S., with a primary outcome of determining whether each FQHC collected data on their patients’ social risk factors. The researchers also estimated the relationship between the characteristics of 7 FQHCs (such as their size, and various Medicare features), and their probability of conducting social risk screening. The study reported that 71% of FQHCs collected information on social risks, with variances between states. The researchers concluded that while the majority of FQHCs collect data on social risk factors, there are disparities between different states, and that smaller FQHCs may benefit from having social risk screening resources focused on them and may increase their use of screening tools and practices.
Citation: Cole MB, Nguyen KH, Byhoff E, Byhoff E . Screening for social risk at federally qualified health centers: a national study. Am J Prev Med 2022 May;62(5):670-78. doi: 10.1016/j.amepre.2021.11.008..
Keywords: Social Determinants of Health, Vulnerable Populations, Screening
Steeves-Reece AL, Totten AM, Broadwell KD
Social needs resource connections: a systematic review of barriers, facilitators, and evaluation.
The purpose of this mixed-studies review was to evaluate how studies assess social needs (for example, food and housing) resource connections and identifies the factors reported by patients and caregivers that that may prevent or facilitate connections to resources. The researchers developed a priori selection criteria which were used in a dual review to select PubMed and CINAHL articles published from October 2015 to December 2020. Data was analyzed in 2021. The researchers identified 34 articles from 32 studies and created a taxonomy of resource connection measures with 4 categories: 1) whether participants had contact with resources; 2) whether participants received resources; 3) whether participants had their social needs addressed; or 4) whether participants rated some aspect of their experience with resources. Barriers to resource connections included inadequacy, inaccessibility, fears surrounding stigma or discrimination, staff training, and others. Facilitators included relevancy, degree of support within the interventions, inclusivity of the interventions, and others. The authors concluded that this review study highlights variables that can be addressed to improve the screening of social needs and referral interventions.
Citation: Steeves-Reece AL, Totten AM, Broadwell KD . Social needs resource connections: a systematic review of barriers, facilitators, and evaluation. Am J Prev Med 2022 May;62(5):e303-e15. doi: 10.1016/j.amepre.2021.12.002..
Keywords: Social Determinants of Health, Screening
Vasan A, Darko O, Fortin K
Community resource connection for pediatric caregivers with unmet social needs: a qualitative study.
The authors aimed to explore caregivers' perceived barriers to and facilitators of community resource connection. Through semi-structured interviews, they identified four primary themes, including competing priorities and burdensome application processes. They recommended electronic resources to help caregivers identify locally available services, with longitudinal supports to ensure caregivers can establish and maintain linkages with these services.
Citation: Vasan A, Darko O, Fortin K . Community resource connection for pediatric caregivers with unmet social needs: a qualitative study. Acad Pediatr 2022 Apr;22(3):461-69. doi: 10.1016/j.acap.2021.09.010..
Keywords: Children/Adolescents, Caregiving, Social Determinants of Health
Murray E, Roosevelt GE, Vogel JA
Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic.
Researchers sought to evaluate a screening and referral program for health-related social needs (HRSN) in an emergency department. Using the Accountable Health Communities Screening Tool, they found that, during the COVID-19 pandemic, HRSN doubled, likely reflecting the economic impact of the pandemic.
Citation: Murray E, Roosevelt GE, Vogel JA . Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic. Am J Emerg Med 2022 Apr;54:323.e1-23.e4. doi: 10.1016/j.ajem.2021.09.071..
Keywords: COVID-19, Social Determinants of Health, Emergency Department, Screening, Public Health
de Loizaga SR, Schneider K, Beck AF
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
In a retrospective cohort analysis of infants enrolled in the National Pediatric Cardiology Improvement Collaborative, researchers investigated the impact of community-level deprivation on morbidity and mortality for infants with single ventricle heart disease in the first year of life. They found that community deprivation was associated with mortality and length of stay for patients with single ventricle congenital heart disease. While patients near the mean deprivation index had a higher hazard of one year mortality compared to those at the extremes of the deprivation index, length of stay and deprivation index were linearly associated, demonstrating the complex nature of socioeconomic factors.
Citation: de Loizaga SR, Schneider K, Beck AF . Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry. Pediatr Cardiol 2022 Mar;43(3):605-15. doi: 10.1007/s00246-021-02763-2..
Keywords: Children/Adolescents, Social Determinants of Health, Quality Improvement, Quality of Care, Cardiovascular Conditions, Registries, Outcomes
Dennett JM, Baicker K
Medicaid, health, and the moderating role of neighborhood characteristics.
The purpose of this study was to evaluate whether the characteristics of different neighborhoods have an impact on the interaction between local environment and the effect of health insurance on health. The researchers utilized existing data from the Oregon Health Insurance Experiment and combined it with new, expanded data on neighborhood characteristics to assess whether those characteristics impacted the relationship between getting health insurance and health outcomes. The study found that the multiple domains of neighborhood characteristics did not affect the correlation between insurance and health outcomes, and concluded that Medicaid expansions do not differ greatly in effectiveness across neighborhoods.
Citation: Dennett JM, Baicker K . Medicaid, health, and the moderating role of neighborhood characteristics. J Urban Health 2022 Feb;99(1):116-33. doi: 10.1007/s11524-021-00579-2..
Keywords: Medicaid, Social Determinants of Health, Health Insurance
Carroll AR, Hall M, Brown CM
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
This retrospective cohort study evaluated the associations of race/ethnicity and social determinants with 90-day rehospitalization of children with mental health conditions to acute non-psychiatric children’s hospitals. Children included were aged 5 to 18 years at 32 freestanding U.S. children’s hospitals from 2016-2018 using the Children’s Hospital Association’s Pediatric Health Information System (PHIS) database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Among 23,556 index hospitalizations, 5.9% (n = 1382) were rehospitalized for mental health within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children. Those with government insurance were 18% more likely to rehospitalized than those with private insurance. Those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location.
Citation: Carroll AR, Hall M, Brown CM . Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals. J Pediatr 2022 Jan;240:228-34.e1. doi: 10.1016/j.jpeds.2021.08.078..
Keywords: Children/Adolescents, Hospital Readmissions, Behavioral Health, Social Determinants of Health, Racial / Ethnic Minorities
Frehn JL, Brewster AL, Shortell SM
Comparing health care system and physician practice influences on social risk screening.
This study examined the association of multilevel organizational capabilities and adoption of social risk screening among system-owned physician practices. A secondary analysis of the 2018 National Survey of Healthcare Organizations and Systems data was conducted. Five social risks were used as measures for physician and system screening: food insecurity, housing instability, utility needs, interpersonal violence, and transportation needs. System-owned practices screened an average of 1.7 of the 5 social risks assessed. The differences were 16% attributable to practice variation between their health system owners, and 84% attributable to differences between individual practices. Practices owned by hospital systems screened for an additional 0.44 social risks relative to practices of systems without hospitals. Characteristics associated with more social risk screening included health information technology capacity, innovation culture, and patient engagement strategies.
AHRQ-funded; HS024075; HS022241.
Citation: Frehn JL, Brewster AL, Shortell SM . Comparing health care system and physician practice influences on social risk screening. Health Care Manage Rev 2022 Jan-Mar;47(1):E1-e10. doi: 10.1097/hmr.0000000000000309..
Keywords: Healthcare Systems, Social Determinants of Health, Screening, Risk
Shadowen H, O'Loughlin K, Cheung K
Exploring the relationship between community program location and community needs.
Investigators identified and geolocated community programs in Richmond, Virginia, that aid with 9 domains of needs. They identified 280 community programs that provide aid for the 9 domains, with programs most often providing financial assistance and housing support. They found no relationship between the number of community programs and the level of need, with 2 exceptions: A positive association between financial programs and financial need, and a negative association between housing programs and housing need. They concluded that community programs were generally not co-located with need.
Citation: Shadowen H, O'Loughlin K, Cheung K . Exploring the relationship between community program location and community needs. J Am Board Fam Med 2022 Jan-Feb;35(1):55-72. doi: 10.3122/jabfm.2022.01.210310..
Keywords: Social Determinants of Health, Community-Based Practice
Lin JS, Hoffman L, Bean SI
Addressing racism in preventive services: methods report to support the US Preventive Services Task Force.
The purpose of this report was to articulate the definitional and conceptual issues around racism and health inequity and to describe how racism and health inequities are currently addressed in preventive health. An audit was conducted assessing published literature on policy and position statements addressing racism, a subset of cancer and cardiovascular topics in USPSTF reports, recent systematic reviews on interventions to reduce health inequities, and societies, organizations, agencies, and funding bodies to gather information about how they address racism and health equity. Findings showed that racism is complex and pervasive, operates at multiple interrelated levels, and exerts negative effects on other social determinants and health and well-being through multiple pathways. The most directly relevant and immediately useful guidance identified is that from the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group.
Citation: Lin JS, Hoffman L, Bean SI . Addressing racism in preventive services: methods report to support the US Preventive Services Task Force. JAMA 2021 Dec 21;326(23):2412-20. doi: 10.1001/jama.2021.17579..
Keywords: U.S. Preventive Services Task Force (USPSTF), Social Determinants of Health, Racial / Ethnic Minorities, Disparities, Research Methodologies, Prevention, Evidence-Based Practice
Razon N, Hessler D, Bibbins-Domingo K
How hypertension guidelines address social determinants of health: a systematic scoping review.
Patient-level and community-level social and economic conditions impact hypertension risk and control. In this study, the investigators examined adult hypertension management guidelines to explore whether and how existing guidelines refer to social care activities. The investigators concluded that information about social determinants of health is included in many hypertension guidelines, but few guidelines provide clear guidance for clinicians or health systems on how to identify and address social risk factors in the context of care delivery.
Citation: Razon N, Hessler D, Bibbins-Domingo K . How hypertension guidelines address social determinants of health: a systematic scoping review. Med Care 2021 Dec;59(12):1122-29. doi: 10.1097/mlr.0000000000001649..
Keywords: Hypertension, Social Determinants of Health, Guidelines, Evidence-Based Practice
Heller CG, Rehm CD, Parsons AH
The association between social needs and chronic conditions in a large, urban primary care population.
This study sought to understand the association between social needs and chronic health conditions using a screening tool and clinical data from Electronic Health Records. From April 2018 to December 2019, 33,550 adult patients completed a 10-item social needs screening tool during primary visits in Bronx and Westchester Counties, NY. A positive, cumulative association between social needs and each of the eight outcomes asked about was found. The relationship was strongest for elevated PHQ-2 (depression screening), alcohol/drug use disorder, and smoking. Those with 3 or greater social needs were 3.9 times more likely to have an elevated PHQ-2 than those without needs. Healthcare transportation challenges was associated with each condition and was the most strongly associated need with half of conditions in the fully-adjusted models. Examples included those with an alcohol/drug use disorder (84% more likely), and smokers (41% more likely).
Citation: Heller CG, Rehm CD, Parsons AH . The association between social needs and chronic conditions in a large, urban primary care population. Prev Med 2021 Dec;153:106752. doi: 10.1016/j.ypmed.2021.106752..
Keywords: Chronic Conditions, Urban Health, Primary Care, Low-Income, Social Determinants of Health, Screening
Wang M, Pantell MS, Gottlieb LM
Documentation and review of social determinants of health data in the EHR: measures and associated insights.
Electronic Health Records (EHRs) increasingly include designated fields to capture social determinants of health (SDOH). The investigators developed measures to characterize their use, and use of other SDOH data types, to optimize SDOH data integration. The investigators concluded for their institution, measures revealed substantial variation across data types, suggesting the need to engage in efforts such as EHR-user education and targeted workflow integration. They also concluded that measures revealed opportunities to optimize SDOH data documentation and review.
Citation: Wang M, Pantell MS, Gottlieb LM . Documentation and review of social determinants of health data in the EHR: measures and associated insights. J Am Med Inform Assoc 2021 Nov 25;28(12):2608-16. doi: 10.1093/jamia/ocab194..
Keywords: Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Fleming MD, Shim JK, Yen I
Managing the "hot spots": health care, policing, and the governance of poverty in the US.
This research looked at a form of surveillance and intervention by health care systems known as “hot spotting”, which targets high-cost patients who are super-utilizers of emergency departments with intensive health and social services. An ethnographic investigation of hot spotting’s modes of distribution and its workings in the lives of patients and providers found that it targets the same individuals and neighborhoods as the police, who maintain longer-standing practices of hot spotting in zones of racialized urban poverty. The boundaries between them are shifting as a financialized logic of governance has come to dominate both the health and criminal justice systems.
Citation: Fleming MD, Shim JK, Yen I . Managing the "hot spots": health care, policing, and the governance of poverty in the US. Am Ethnol 2021 Nov;48(4):474-88. doi: 10.1111/amet.13032..
Keywords: Low-Income, Social Determinants of Health, Vulnerable Populations
Fraze TK, Beidler LB, Fichtenberg C
Resource brokering: efforts to assist patients with housing, transportation, and economic needs in primary care settings.
This study reviewed how 29 diverse health care organizations assisted patients with housing, transportation, and economic needs in primary care settings. Semistructured interviews were conducted with leaders and frontline staff. Organizations used case management programs to assist patients with social needs through referrals to community-based organizations (CBOs) and regular follow-up. About one-half incorporated care into established case management programs, and the remaining described standalone programs. While all organizations referred patients to CBOs, some also provided more intense services such as assistance in completing patients’ applications for services or conducting home visits. Challenges described by the organizations include: 1) effectively engaging CBOs; 2) obtaining buy-in from clinical staff; 3) considering patients' perspectives; and 4) ensuring program sustainability.
Citation: Fraze TK, Beidler LB, Fichtenberg C . Resource brokering: efforts to assist patients with housing, transportation, and economic needs in primary care settings. Ann Fam Med 2021 Nov-Dec;19(6):507-14. doi: 10.1370/afm.2739..
Keywords: Social Determinants of Health, Primary Care, Care Management
Davidson KW, Krist AH, Tseng CW
AHRQ Author: Mills J, Borsky A
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
The authors assessed how social risks have been considered in USPSTF recommendation statements and identified current gaps in evidence needed to expand the systematic inclusion of social risks in future recommendations. They concluded that their report serves as a benchmark and foundation for ongoing work to advance the goal of ensuring that health equity and social risks are incorporated into USPSTF methods and recommendations.
Citation: Davidson KW, Krist AH, Tseng CW . Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care. JAMA 2021 Oct 12;326(14):1410-15. doi: 10.1001/jama.2021.12833..
Keywords: U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Risk, Evidence-Based Practice, Research Methodologies, Guidelines
Wallace AS, Luther BL, Sisler SM
Integrating social determinants of health screening and referral during routine emergency department care: evaluation of reach and implementation challenges.
Despite the importance of social determinants in health outcomes, little is known about the best practices for screening and referral during clinical encounters. This study aimed to implement universal social needs screening and community service referrals in an academic emergency department (ED), evaluating for feasibility, reach, and stakeholder perspectives. The investigators concluded that despite the limited time and technical barriers, few patients with social needs ultimately received service referrals.
Citation: Wallace AS, Luther BL, Sisler SM . Integrating social determinants of health screening and referral during routine emergency department care: evaluation of reach and implementation challenges. Implement Sci Commun 2021 Oct 7;2(1):114. doi: 10.1186/s43058-021-00212-y..
Keywords: Social Determinants of Health, Emergency Department, Screening, Implementation
Fiori KP, Heller CG, Flattau A
Scaling-up social needs screening in practice: a retrospective, cross-sectional analysis of data from electronic health records from Bronx county, New York, USA.
This study describes a health system’s experience from 2018 to 2020 to scale social needs of screening of patients within a large urban primary care ambulatory network. This program took place at an academic medical center within an ambulatory network of 18 primary care practices located in the Bronx, New York. The study used electronic health records of 244,764 patients who had a clinical visit from April 2018 to 2019. The authors organized measures using the RE-AIM framework domains of reach and adoption to ascertain the number of patients who were screened and the number of providers who adopted screening. A total of 53,093 patients were screened for social needs, representing 21.7% of the patients seen. Almost one-fifth (19.6%) of patients reported at least one unmet social need, varying by both practice location and specialty within practices. Slightly more than half (51.8%) of providers screened at least one patient.
Citation: Fiori KP, Heller CG, Flattau A . Scaling-up social needs screening in practice: a retrospective, cross-sectional analysis of data from electronic health records from Bronx county, New York, USA. BMJ Open 2021 Sep 29;11(9):e053633. doi: 10.1136/bmjopen-2021-053633..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Screening, Social Determinants of Health
O'Kane M, Agrawal S, Binder L
AHRQ Author: Meyers D
An equity agenda for the field of health care quality improvement.
The authors of this paper assert that the U.S. health system must take action to centralize equity, particularly racial equity (including ethnicity), in discussions of quality. In this discussion paper, the authors provide an analysis and delineation of the key elements of their racial equity agenda for the field of health care quality improvement.
Citation: O'Kane M, Agrawal S, Binder L . An equity agenda for the field of health care quality improvement. NAM Perspect 2021 Sep 15;2021. doi: 10.31478/202109b..
Keywords: Quality Improvement, Quality of Care, Racial / Ethnic Minorities, Disparities, Social Determinants of Health
Linton SL, Leifheit KM, McGinty EE
Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic.
This research letter describes a survey study conducted to examine the association between housing insecurity and health during the COVID-19 pandemic. Data used was from wave 3 of the Johns Hopkins COVID-19 Civic Life and Public Health Survey, which was conducted online from November 11-30, 2020 using the National Opinion Research Center’s AmeriSpeak panel. The survey included 1218 participants who were 51% female, 560 participants aged 30 to 54 years, 549 participants aged 55 years or older; 13% self-identified as Hispanic, 13% self-identified as non-Hispanic Black, and 69% self-identified as non-Hispanic White. In November 2020, 128 participants (12%) reported housing insecurity. Among survey participants reporting housing insecurity, 42 reported being behind on housing payments, 55 reported having little to no confidence in their ability to make their next housing payment, and 31 reported both. Renters had disproportionately higher housing insecurity than homeowners, as did those were non-Hispanic Black race, were aged 30 to 54 years, earned less than $35,000 in 2019, lived with children, or resided in metropolitan counties. Forty-six percent of participants reported severe to moderate psychological distress and 18% reported fair to poor health. Participants with housing insecurity reported higher distress (57% vs 45%) and lower self-rated health (30% vs 16%). The association between housing insecurity and lower self-rated health was found to be statistically significant, while the association between housing insecurity and higher distress was not.
Citation: Linton SL, Leifheit KM, McGinty EE . Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic. JAMA Netw Open 2021 Sep;4(9):e2127772. doi: 10.1001/jamanetworkopen.2021.27772..
Keywords: COVID-19, Health Status, Stress, Social Determinants of Health
Parker MG, Garg A, Brochier A
Approaches to addressing social determinants of health in the NICU: a mixed methods study.
The objective of this study was to examine current approaches to addressing social determinants of health (SDOH) in the NICU and perceived appropriateness of a standardized screening and referral process. The investigators performed a mixed methods study in two Massachusetts safety-net NICUs. They concluded that current NICU assessment of SDOH was limited and use of a standardized screening and referral process could be useful.
Citation: Parker MG, Garg A, Brochier A . Approaches to addressing social determinants of health in the NICU: a mixed methods study. J Perinatol 2021 Aug;41(8):1983-91. doi: 10.1038/s41372-020-00867-w..
Keywords: Social Determinants of Health, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)
Izadi Z, Li J, Evans M
Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis.
This longitudinal study looked at the association of socioeconomic disparities and functional status in a national sample of patients with rheumatoid arthritis (RA). This study used a cohort from the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) registry from 2016 to 2018. Analyses included all adult patients with a confirmed RA diagnosis and at least 1 functional status (FS) score documented. The Area Deprivation Index (ADI), a zip code-based indicator of poverty, was used as a proxy for socioeconomic status (SES). The cohort included 83,965 patients, of which 77% were women and 72% were non-Hispanic White. Mean age was 63.4 years. The probability of functional decline was 14.1% in the highest SES quintile and 18.9% in the lowest SES quintile. By all measures FS score was worse at lower SES levels.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Li J, Evans M . Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis. JAMA Netw Open 2021 Aug 2;4(8):e2119400. doi: 10.1001/jamanetworkopen.2021.19400..
Keywords: Arthritis, Chronic Conditions, Disparities, Social Determinants of Health, Quality of Life