Husker examines how social factors impact patient health

A University of Nebraska–Lincoln pre-med student’s research project is shedding light on how a patient’s healing often may be affected by social factors not directly addressed by a hospital visit.

Learning more about these social factors and how hospitals can help patients address these needs was the focus of Jocelyn Daubendiek’s undergraduate internship at the University of Nebraska Medical Center in Omaha. She will present results of this research at the Hospital Medicine National Conference in Washington, D.C., in March.

Daubendiek, a biochemistry major from Elkhorn, studied the social determinants of health of UNMC internal medicine patients through a summer undergraduate research program. Her project mentor was Dr. Rachel Thompson, division chief for hospital medicine, General Internal Medicine.

Social determinants of health are the social or economic factors in a person’s life that affect their overall health. These include the ability to pay for housing, food, utilities and other necessities; access to reliable transportation; exposure to violence or unsafe living conditions; education level; and overall social or emotional well-being. The purpose of the research project was to evaluate these social and economic factors of UNMC internal medicine patients and to assess the hospital as a potential environment for screening for social factors.

“Patients are usually screened for these social determinants at the primary care level, but because many patients with needs may not see a primary care provider, the hospital might be an appropriate place to discover social needs and help patients find resources to meet those needs,” Daubendiek said.

Daubendiek interviewed internal medicine patients and reviewed their medical record to discover social needs and whether any items in the medical record correlated significantly with the presence of social needs.

More than 60 percent of internal medicine patients in the study had at least one social need. The four most common needs were difficulty paying for basic needs (food, housing, medical care and heating), feeling lonely or socially isolated from other people, in need of screening for depression, and having food insecurity.

“The fact that so many patients in the hospital do in fact have unmet needs suggests that the hospital is a good setting to screen patients for needs,” Daubendiek said.

By comparing needs and medical records, she found that the rates of social needs were higher for patients who had a history of drug or alcohol abuse, who were currently smokers, who had no primary care provider or health care insurance, or who had no spouse or partner.

“This knowledge could help providers and social work staff by giving them a better idea of what needs to look for in patients and what resources might be most helpful to the patient population at UNMC,” Daubendiek said.

Ultimately, she said this medical record information could potentially be used to flag patient records that meet one or more of these categories, so providers will know which patients might benefit from an in-depth social needs screening.

Daubendiek plans to continue the study in the summer, asking patients about their social needs and determining which resources would be most helpful to them.