A recent article in the September 2016
American Psychologist entitled, “Collecting Psychosocial Vital Signs in Electronic Health Records: Why Now? What are they? What’s new for Psychology?” introduces us to the concept of social determinants of health (SDOH) as key “vital signs” to be screened in primary care. Social determinants of health encompass the social and economic variables that impact individuals; the authors broaden this to include behavioral and psychological factors. SDOH variables play a substantial role (estimated 20-40%) in overall health status and outcomes. This article references multiple studies that support the importance of SDOH on health outcomes, including mortality.
As psychologists, we have a history of researching and working with clients within this realm, yet this article articulates a thought process regarding use of SDOH vital signs for other causes - to propel primary care psychology forward and further the psychologist role and expert status in population health management.
The Institute of Medicine released two reports in 2014 on capturing SDOH in medical records. They recommended the collection of several variables to obtain this essential health data including financial resource strain, depression, social connectedness, stress, intimate partner violence, physical activity, tobacco use, and alcohol use. Main ingredients here are whether the variable was “actionable” (or useful) and screening question/tool readiness; each essential data point has a simple screening tool/question recommendation. Research studies are being carried out currently in this area.
Think of the research and practice opportunities this creates for psychologists. Can you imagine being a leader for primary care in the measurement of psychosocial vital signs AND the action plans and workflows associated with these variables once identified? Can you imagine creating a risk stratification approach for primary care to assist them in using these variables and determining high, moderate, and low risk patient populations and associated population health management protocols? Can you imagine what the collective capture and use of this data across communities could do for creating community health initiatives? For those not in integration but coordinating care with general health providers, what could it mean to be able to provide a vital signs report to your referral sources?
This
article in American Psychologist is worth your read. Below you will find several links that provide further information on SDOH and current research/screening initiatives.
https://www.nationalacademies.org/hmd/Activities/PublicHealth/SocialDeterminantsEHR.aspx
http://frontiersofhealthcare.com/2016/08/assess-do-integrating-social-determinants-of-health-into-primary-care/
http://kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/
https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources
http://www.cdc.gov/socialdeterminants/
Contributor:
Carrie Cadwell, Psy.D., HSPP
IPA President
Four County Counseling Center
"PsychBytes” is a weekly educational resource from the Indiana Psychological Association (IPA) provided for psychologists, their colleagues and their patients.
