Improving Maternal Health Through SDoH Screenings

topic area

Social Determinants of Health

status

Dissemination

about

Social Determinants of Health (SDoH) are structural and social drivers of health outcomes — negative SDoH, such as racism, poverty, poor housing conditions, lack of access to primary and specialty care, and stigma, can drive health inequities. Screening for negative SDoH during prenatal care may be useful to
connect pregnant patients to necessary resources during pregnancy.

During this pilot project, the AHE research team set out to better understand provider and patient perspectives and experiences around SDoH screenings and referrals. The team developed interview guides, and recruited patients and providers from across the health system to representative samples
of different provider roles, length of service, place of work, and patient age, pregnancy term, and location of obstetrics (OB) services. The team conducted interviews and analyzed the data to determine how providers can improve their care to better meet the needs of patients.

The AHE team has submitted research papers to academic journals to publish and help disseminate the findings from the project.

findings and impact

As heath systems continue to mandate SDoH screenings, it is crucial that we understand patient and provider preferences to make these screenings effective and non-stigmatizing for our patients. This study found that both patients and providers only find these screenings useful if there is action to be taken when an SDoH need is identified. The result of the screenings should drive next steps to identify appropriate and accessible referrals and interventions for patients.

With a lack of resources, in addition to a larger lack of understanding of what resources currently exist in an evershifting landscape, it’s difficult to close the loop for patients who identified as needing assistance. Given our broad reach across health systems, we are well-positioned to help tackle some of the gaps in the current SDoH landscape. The AHE SDoH Subcommittee is currently exploring ways to compile and provide a list of up-to-date resources for health systems,
social workers, and CHWs to utilize when patients identify an SDoH need.

There’s also room for innovation in this space to help alleviate the burden on physicians by updating reimbursement models. Physicians can be reimbursed for mental health screenings for patients, but SDoH screenings fall outside of that category. Standardized reimbursement practices between payors for screenings could support physicians in allocating the time and resources needed for SDoH screenings and discussions, helping to improve the process and bolster screening rates.

looking ahead

The AHE research team hopes to work with OB teams to develop a playbook for implementing SDoH screening and referral practices in OB settings to help improve health outcomes for pregnant patients. Ideally, these findings from the project partnership with Penn Medicine would be shared with OB teams across Philadelphia health systems to improve healthcare for patients city-wide. AHE’s SDoH subcommittee will focus on making concrete recommendations for health systems, payors, and physicians to increase screening rates and improve the referral process across systems.