Screening and social prescribing in healthcare and social services to address housing issues among children and families: a systematic review

Abstract

ObjectivesHousing is a social determinant of health that impacts the health and well-being of children and families. Screening and referral to address social determinants of health in clinical and social service settings has been proposed to support families with housing problems. This study aims to identify housing screening questions asked of families in healthcare and social services, determine validated screening tools and extract information about recommendations for action after screening for housing issues.MethodsThe electronic databases MEDLINE, PsycINFO, EMBASE, Ovid Emcare, Scopus and CINAHL were searched from 2009 to 2021. Inclusion criteria were peer-reviewed literature that included questions about housing being asked of children or young people aged 0–18 years and their families accessing any healthcare or social service. We extracted data on the housing questions asked, source of housing questions, validity and descriptions of actions to address housing issues.ResultsForty-nine peer-reviewed papers met the inclusion criteria. The housing questions in social screening tools vary widely. There are no standard housing-related questions that clinical and social service providers ask families. Fourteen screening tools were validated. An action was embedded as part of social screening activities in 27 of 42 studies. Actions for identified housing problems included provision of a community-based or clinic-based resource guide, and social prescribing included referral to a social worker, care coordinator or care navigation service, community health worker, social service agency, referral to a housing and child welfare demonstration project or provided intensive case management and wraparound services.ConclusionThis review provides a catalogue of housing questions that can be asked of families in the clinical and/or social service setting, and potential subsequent actions.

Upstream Policy Changes to Improve Population Health and Health Equity: A Priority Agenda

“…Housing and social services are fundamentally important because they are supposed to protect the most vulnerable population: children. 37 In this special issue, Medipanah notes that affordable housing as well as homeownership rates are key upstream drivers of health inequality. 38 Collectively, these issues speak to environmental challenges driven by racial residential segregation.…”

“…For example, places that lack an efficient social service infrastructure also have serious problems with housing affordability and instability. Housing and social services are fundamentally important because they are supposed to protect the most vulnerable population: children 37 . In this special issue, Medipanah notes that affordable housing as well as homeownership rates are key upstream drivers of health inequality 38…”

Social determinants of health screening in pediatric healthcare settings

“…Healthy People 2030 groups SDOH into five domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context [1]. Over the past 2 years, pediatric literature has primarily focused on the domains of food insecurity/nutrition [10 ▪ ,22] and housing insecurity/housing conditions [23 ▪ ,24 ▪ ]. This is likely because of concrete social outcomes associated with community referrals (i.e., improving housing conditions/stability, and access to benefits like the Supplemental Nutrition Assistance Program), and prevalence within the pediatric population [22].…”

Social prescribing in pharmacies: What is it, does it work and what does it mean for Canadian pharmacies?

“…Once awareness has been achieved, tools to formalize the screening and referral of patients to social prescribing link workers or programs will need to be established. Tools currently exist focusing on specific social determinants of health, for example, on housing 25 and loneliness, 26 and include completing forms PRaCtiCe BRief setting out the health care professional's concerns or making a phone call to the social prescribing team. 27 Tools, such as the UCLA Loneliness Scale, are available for health professionals to screen patients to identify who may benefit from referral to a link worker.…”