Employment Interventions in Health Settings: A Systematic Review and Synthesis

Pinto, Andrew D.; Hassen, Nadha; Craig-Neil, Amy

doi:10.1370/afm.2286

Cited by 30 publications

(28 citation statements)

References 124 publications

(123 reference statements)

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“…It did, however, point to the potential for embedded employment specialists or partnerships with community agencies to improve employment outcomes for patients. 51 Housing interventions, although impactful, have almost exclusively been studied in specialized health care settings that provide services to people experiencing homelessness. 52 Transportation to medical appointments has been identified as a determinant of access to care, and interventions may enable clients to connect with health care services.…”

Section: Employment Housing Transportation and Food Securitymentioning

confidence: 99%

Implementing social interventions in primary care

Bloch

Rozmovits

2021

CMAJ

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Section: Employment Housing Transportation and Food Securitymentioning

confidence: 99%

Implementing social interventions in primary care

Bloch

Rozmovits

2021

CMAJ

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“…16 Evidence is also beginning to accumulate for interventions that embed lawyers in clinical settings (medical−legal partnerships) 17 and for employment interventions. 18 Outside of these more rigorously designed studies, however, the literature is still sparse. Many existing studies have evaluated intervention impacts on process outcomes only, such as the number of people screened and the number receiving navigation services, and not on outcomes such as social needs, health conditions, health services utilization, or costs.…”

Section: Effectiveness: What Work How and What Work Best?mentioning

confidence: 99%

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

Fichtenberg

Alley

Mistry

2019

American Journal of Preventive Medicine

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Spurred by accumulated evidence documenting how social determinants of health shape health outcomes as well as the push for better value, the healthcare sector is embracing interventions that address patients' health-related social needs. An increasing number of healthcare organizations and payers are experimenting with strategies to identify needs and connect patients to resources that address identified needs with the goal of improving health outcomes, reducing avoidable utilization of costly health services, and improving health equity. Although many studies link social factors to health, relatively little published research exists about how the healthcare sector can effectively intervene to help identify and address social needs. This paper summarizes emerging evidence and identifies key areas where more research is needed to advance implementation and policy development. Although some healthcare-based social needs interventions have been shown to improve health and reduce avoidable utilization, important gaps remain in terms of comparative effectiveness and cost effectiveness of social needs intervention approaches. Additionally, the field would benefit from an increased understanding of mechanisms of action to maximize practitioners' ability to tailor interventions. More research is also needed to guard against unintended consequences and ensure these interventions reduce health inequities. Finally, implementation science research should identify supports and incentives for adoption of effective interventions. Focusing both public and private research efforts on these evidence gaps can help advance identification of interventions that maximize both health equity and healthcare value.

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“…31 and prospective employers. 32 The authors highlight the importance of increasing (1) understanding among primary care staff of employment as a social determinant of health and (2) linkages to social/ community health workers and external employment services. Similar approaches have been recommended for unemployed persons with physical limitations.…”

Section: Discussionmentioning

confidence: 99%

Employment status, unemployment duration, and health‐related metrics among US adults of prime working age: Behavioral Risk Factor Surveillance System, 2018–2019

Silver

Quay

2021

American J Industrial Med

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Background: While unemployment has been associated with poor health, few recent studies in the United States have comprehensively assessed associations between employment status (including duration unemployed) and healthcare access, healthrelated behaviors, and specific health outcomes. Methods:We assessed health-related metrics by employment status in 2018-2019 Behavioral Risk Factor Surveillance System respondents ages 25-54. We calculated the unadjusted prevalence and adjusted prevalence ratios to compare employed workers to respondents who were self-employed, short-term (<12 months) unemployed, long-term unemployed, and unable to work.Results: Adverse health outcomes increased with unemployment duration and were highest for those unable to work. Non-Hispanic Blacks were most likely to be unemployed or unable to work. Short-term unemployment and self-employment were associated with poor healthcare access. Health behaviors and outcomes declined with increasing duration of unemployment and were worst for those unable to work.Conclusions: In the United States, access to affordable healthcare is problematic for both the self-employed and the short-term unemployed. Short-term unemployment is a particularly important locus for intervention and provision of resources to prevent health declines that may hinder re-employment.

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Employment Interventions in Health Settings: A Systematic Review and Synthesis

Cited by 30 publications

References 124 publications

Implementing social interventions in primary care

Implementing social interventions in primary care

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

Employment status, unemployment duration, and health‐related metrics among US adults of prime working age: Behavioral Risk Factor Surveillance System, 2018–2019

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