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Social determinants of health correlations and resource usefulness at a Milwaukee free clinic for uninsured individuals: A cross-sectional study. J Clin Transl Sci 2024;8(1):e71

Date

05/01/2024

Pubmed ID

38690226

Pubmed Central ID

PMC11058579

DOI

10.1017/cts.2024.503

Scopus ID

2-s2.0-85190098294 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: Addressing social determinants of health (SDOH) is fundamental to improving health outcomes. At a student-run free clinic, we developed a screening process to understand the SDOH needs and resource utilization of Milwaukee's uninsured population.

METHODS: In this cross-sectional study, we screened adult patients without health insurance (N = 238) for nine traditional SDOH needs as well as their access to dental and mental health care between October 2021 and October 2022. Patients were surveyed at intervals greater than or equal to 30 days. We assessed correlations between SDOH needs and trends in patient-reported resource usefulness.

RESULTS: Access to dental care (64.7%) and health insurance (51.3%) were the most frequently endorsed needs. We found significant correlations (P ≤ 0.05) between various SDOH needs. Notably, mental health access needs significantly correlated with dental (r = 0.41; 95% CI = 0.19, 0.63), medications (r = 0.51; 95% CI = 0.30, 0.72), utilities (r = 0.39; 95% CI = 0.17, 0.61), and food insecurity (r = 0.42; 95% CI = 0.19, 0.64). Food-housing (r = 0.55; 95% CI = 0.32, 0.78), housing-medications (r = 0.58; 95% CI = 0.35, 0.81), and medications-food (r = 0.53; 95% CI = 0.32, 0.74) were significantly correlated with each other. Longitudinal assessment of patient-reported usefulness informed changes in the resources offered.

CONCLUSIONS: Understanding prominent SDOH needs can inform resource offerings and interventions, addressing root causes that burden under-resourced patients. In this study, patient-reported data about resource usefulness prompted the curation of new resources and volunteer roles. This proof-of-concept study shows how longitudinally tracking SDOH needs at low-resource clinics can inform psychosocial resources.

Author List

Miller J, Doucas A, Karra H, Thareja SK, Bowie O, Dong X, Terrell J, Hernandez S, Corujo-Ramirez AM, Xia N, Qi S, Huang CC, Lundh R, Young SA

Author

Staci A. Young PhD Sr Associate Dean, Associate Director, Professor in the Family Medicine department at Medical College of Wisconsin