Social Risk Screening and Response Equity: Assessment by Race, Ethnicity, and Language in Community Health Centers.
Social Risk Screening and Response Equity: Assessment by Race, Ethnicity, and Language in Community Health Centers.
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DOI：
10.1016/j.amepre.2023.02.018
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发表时间：
2023-08
影响因子：
5.5
通讯作者：
Gottlieb, Laura M.
中科院分区：
文献类型：
--
作者：
Torres, Cristina I. Huebner;Gold, Rachel;Kaufmann, Jorge;Marino, Miguel;Hoopes, Megan J.;Totman, Molly S.;Aceves, Benjamin;Gottlieb, Laura M.
Little has previously been reported about the implementation of social risk screening across racial / ethnic / language (REL) groups. To address this knowledge gap, the associations between REL, social risk screening, and patient-reported social risks were examined among adult patients at community health centers (CHCs). Patient- and encounter-level data from 2016–2020 from 651 CHCs in 21 U.S. states were used; data were extracted from a shared Epic© electronic health record (EHR) and analyzed between December 2020 and February 2022. In adjusted logistic regression analyses stratified by language, robust sandwich variance standard error estimators were applied with clustering on patient’s primary care facility. Social risk screening occurred at 30% of health centers; 11% of eligible adult patients were screened. Screening and reported needs varied significantly by REL. Black Hispanic and Black non-Hispanic patients were approximately twice as likely to be screened, and Hispanic White patients were 28% less likely to be screened, compared to non-Hispanic White patients. Hispanic Black patients were 87% less likely to report social risks compared to non-Hispanic White patients. Among patients who preferred a language other than English or Spanish, Black Hispanic patients were 90% less likely to report social needs compared to non-Hispanic White patients. Social risk screening documentation and patient reports of social risks differed by REL in CHCs. Though social care initiatives are intended to promote health equity, inequitable screening practices could inadvertently undermine this goal. Future implementation research should explore strategies for equitable screening and related interventions.
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