Social Determinants of Health: How Daily Issues Impact Your Patients

Many factors in your patients’ daily lives and their environment affect their physical and emotional health and well-being. Some people may not have a safe, secure place to live. Or they may not have dependable transportation to get to the grocery store or to medical appointments. Others may be financially strapped, and have trouble paying for things like food or medicine.

These nonmedical factors that impact health outcomes are called Social Determinants of Health (SDOH). Addressing SDOH is vital—and that’s where you as a healthcare provider come in. Your patients may not be thinking about discussing these types of nonmedical issues with you. They may feel overwhelmed. Or they may not know how to start the conversation. But you can play a key role in helping patients identify certain problem areas or needs—and directing them to resources that can help.

Below are some of the SDOH issues that may be affecting your patients, along with specific questions to ask them. You’ll also find an SDOH action plan.

SDOH issues, and questions to ask your patients

SDOH concerns encompass many different areas of a person’s life. These are issues and circumstances that people are struggling to deal with–both emotionally and financially. They may have very little control over these things. They may feel embarrassed about their situation. And they may not know that help is available. So it’s important to approach your patients with sensitivity and empathy when talking about these issues. Here are some common SDOH challenges your patients may be facing, and specific questions to ask them.

Housing issues

Some of your patients may not live in a stable housing situation. They may be staying with a friend or relative. Or they may be living in a shelter.

  • What kind of housing do you have right now?
  • How safe do you feel in your current living situation?
  • Are you worried that you won’t have somewhere to live in a few months?

Food concerns

Some people may be food insecure. They may not have regular access to food, or they may not always have enough food for all of their family members.

  • Do you ever worry about how you will pay for food?
  • Have you or any family members gone without food in the past few months?

Transportation needs

Not everyone has a car, or access to public transportation. Without reliable transportation, people may have trouble doing basic tasks, such as food shopping or getting to work, school, or medical appointments.

  • Do you often need help getting to your medical appointments?
  • Do you ever have trouble getting to work, or to the grocery store or pharmacy?

Money concerns

Financial problems are a huge source of stress for many people.

  • Do you sometimes run out of money by the end of the month?
  • In the past year, have you had trouble paying for things such as food, housing, or medicine?
  • In the past year, have you had trouble paying your heating, water, or electric bills?

Medical care and insurance

Lack of medical insurance can lead many people to delay getting the care that they need.

  • Do you have health insurance or a medical card?
  • Do you ever put off getting medical care or buying medicine because of the cost?

Child care

Not having regular child care can be a significant burden. It may make it hard for parents to keep a job or to take classes.

  • Have you had problems getting regular child care in the past year?
  • In the past few months, has lack of child care affected your ability to work? Or go to school?

Other concerns

Once you open up the SDOH conversation, you may find there are other issues your patients need help with as well.

  • Do you have any urgent needs right now?
  • Is there anything else you want to tell me about?

Your SDOH action plan

Here are some things that you can do to address your patients’ SDOH issues during office visits:

  • Assess. When meeting with patients, ask about some of the SDOH issues that they may be dealing with, as listed above. Remember to approach these sensitive issues with care and empathy. Give your patients the list of SDOH screening questions to look over, Everyday Issues and Your Health. This can help prompt them to start talking about their specific concerns with you.
  • Empower. Next, match your patients with the appropriate resources. If specific social needs are identified, talk with your patients about finding assistance. If the patient is open to it, refer them to specific community groups and organizations in your area that can help them, using the SDOH Resource List. Connect them with a social worker, if possible. Does your healthcare organization have a social worker on staff?
  • Evaluate. Follow up with your patients at their next visit. Find out if any specific resources provided were helpful, and how the person is handling things now. If they need more assistance, help direct them to other local or national resources.

To learn more about SDOH

You’ll find more information on the importance of addressing SDOH, and how these issues affect patient health outcomes at: