The terminology of social emergency medicine: Measuring social determinants of health, social risk, and social need

Abstract

Emergency medicine has increasingly focused on addressing social determinants of health (SDoH) in emergency medicine. However, efforts to standardize and evaluate measurement tools and compare results across studies have been limited by the plethora of terms (eg, SDoH, health‐related social needs, social risk) and a lack of consensus regarding definitions. Specifically, the social risks of an individual may not align with the social needs of an individual, and this has ramifications for policy, research, risk stratification, and payment and for the measurement of health care quality. With the rise of social emergency medicine (SEM) as a field, there is a need for a simplified and consistent set of definitions. These definitions are important for clinicians screening in the emergency department, for health systems to understand service needs, for epidemiological tracking, and for research data sharing and harmonization. In this article, we propose a conceptual model for considering SDoH measurement and provide clear, actionable, definitions of key terms to increase consistency among clinicians, researchers, and policy makers.

Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement

“…Also, this lack of common terminology around SDOH is not unique to the care transition intervention literature and additionally makes it difficult for researchers to communicate their findings to other stakeholders like policymakers, the social services sector, and payers. 17 To move the field forward, we agree with the recommendation 16 to use a common agreed-upon language among researchers when describing "social determinants of health," "social risk factors," and "social needs. "…”

“…Social risk factors are individual-level adverse SDOH that are often identified through screening tools (e.g., positive for food insecurity), and social needs are the downstream individual-level needs prioritized by patients (e.g., request for food assistance). [16][17][18] While social risk factors have been noted to contribute to ED use and adverse outcomes, [19][20][21] EDs also face significant challenges in identifying and intervening on social needs. 22,23 Particularly for older adults, the intersection of ED care transitions and SDOH represents a key quality focus.…”

Social Determinants, Risk Factors, and Needs: A New Paradigm for Medical Education

“…Both are critically important. 30 The former has more long-lasting implications and is more broadly effective, while the latter has the potential to offer more immediate relief. Chart 1 contrasts a sampling of these interventions at our school.…”

The Time Is Now: Racism and the Responsibility of Emergency Medicine to Be Antiracist

“…Identifying social risks, specific adverse social conditions associated with poor health specific to the individual, and social needs, determined by an individual’s preferences and priorities, presents the opportunity to actively engage with individual patients and communities on interventions. 60 Emergency medicine professional societies and academic and community practice groups are responding to this call to action of evolving emergency medicine practice to include social emergency medicine in education, research, and advocacy. Organizational support of the practice of social emergency medicine addresses structural racism through actions aimed at positively impacting health outcomes and patient experiences and reducing costs to improve population health.…”