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Findings
Future Directions
Understanding emergency department patient perceptions ofthe social determinants of health through the Stanford Help Desk Jordyn Irwin, Honors in the Program in Human Biology, May 2016
Implications
• Public service plan: disseminate findings and implica0ons to clinics that operate Help Desks in the Bay Area
• Encourage the adop0on of Help Desks with these findings in mind
• Future research: large-‐scale, mul0-‐site cross-‐sec0onal survey and a series of qualita0ve studies
Demographics & Needs
AcknowledgementsMany thanks to my advisors, Dr. Jennifer Newbery and Dr. Donald Barr, the Public Service Scholars Program, and my community partner organiza0on, the Stanford Health Advocates and Research in the Emergency Department (SHARED) Program.
Introduction
Methods
The Social Determinants of Health (SDH) are “the condi0ons in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the condi0ons of daily life.” –World
Health Organiza0on
A large body of research demonstrates that
A much more limited body of research shows that the public holds varied percep>ons of the role of SDH, but that in general, they value SDH as playing a smaller role in impac0ng health outcomes
than do behavior, environment, and healthcare. Very liAle research has been conducted to explore how public percep>ons of
SDH are formed and influenced.
Research Ques0ons: • Ques>on 1: Does the likelihood of experiencing a need in each
of six SDH areas vary across sociodemographic characteris0cs such as income level, educa0on level, and health status?
• Ques>on 2: How do percep0ons of each of the six SDH areas vary between individuals who experience needs in the six areas compared with those who do not?
• Ques>on 3: Are individuals’ percep0ons of how SDH influence their own health associated with their percep0ons of how SDH influence health in general?
Pa>ent Eligibility
Study Design The study was a cross-‐sec0onal survey of a convenience sample of Stanford ED pa0ents who completed the Help Desk interven0on.
The Help Desk Through the Help Desk, health advocates interview ED pa0ents regarding social and legal challenges they may currently face, and connect interested pa0ents to social and legal services.
Health
A. Employment B. Housing
C. Health Insurance D. Primary Care
Demographic characteris0cs and need prevalence in the study popula0on
Likelihood of experiencing a need in each category shown by self-‐reported health status
Average percep0on of how each SDH category impacts health in par0cipants’ own lives, shown by whether or not par0cipants experienced a need in each category
Average Percep>ons shown by Need
Need shown by Health Status Key Contribu>ons • Two-‐thirds of all par0cipants reported experiencing at least
one social need. • Par0cipants with fair or poor health were most likely to
experience a need for employment, housing, and food security.
• Par0cipants’ percep0ons of how each SDH factor impacted health in their own lives varied, and whether or not par0cipants experienced a need in each category contributed to this varia0on.
• Par0cipants perceived their experiences with health insurance and primary care to have the strongest impact on health.
• Most par0cipants perceived experiencing a social need as having a nega>ve impact on people’s health in general.
• Three-‐quarters of par0cipants who received a Help Desk interven0on believed that it would have a posi0ve impact on their health.
Self-‐reported health status
Percep0on of factors that impact
health status
Educa0on incorporated into interven0ons
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