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Health Information | 07/08/2019

Understanding How Environment Affects Health

By  Atrius Health
young children at school

Most of us know that we need to eat healthy foods, get regular exercise, get adequate sleep, and manage stress to stay healthy. But did you know that where you live, work, learn, and play can have just as much impact on your and your child’s health?

Understanding Social Determinants of Health

Social determinants of health are conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Some examples of social determinants include:

  • Access to safe and affordable housing
  • Access to education
  • Disruption in the home environment, such as divorce or loss of a job
  • A safe home/educational/work/play environment
  • Availability and access to healthy foods
  • Access to transportation

Partnering With Our Patients

At Atrius Health, our pediatricians believe in caring for the whole family and developing a deep understanding of the family dynamic to improve the care we provide to our young patients. To do that successfully, we need to understand all aspects of our children’s and their families’ lives that can affect their health. Over the past year, we’ve introduced a standardized questionnaire that we hope will open the lines of communication between our patients and their providers about what’s happening in their lives in between their medical appointments. Our social determinants of health (SDOH) questionnaire consists of nine questions which help us to understand if parents/guardians or patients have any social or environmental barriers that are standing in the way of receiving the health care they need.

This questionnaire gives patients and their families the opportunity to share any worries or concerns they have about losing their home, their employment status, their ability to pay their utilities as well as their access to food, transportation, childcare, and mental health resources. Families across all walks of life can face health-related social needs, and we are here to help connect them with the necessary resources. Therefore, the questionnaire is given to all parents and guardians of patients under the age of 18 and all patients who are 18 or older at the one-month well visit, annual physicals, and new patient visits. The questionnaire takes less than 5 minutes to complete, and responses to the survey are treated with sensitivity and confidentiality. We request that all parents, guardians, and patients complete the questionnaire each year to signify whether they have any barriers to receiving health care.

If a parent, guardian or patient does not have any issues, he or she will have the option to indicate that there are no needs as well as an option to respond “I choose not to answer this question” for each question on the survey. We are always glad to know that a patient’s family has no social needs or barriers that may limit their ability to receive the best possible healthcare. However, families’ circumstances can change, and we hope to identify through annual screening any social challenges they face so that our providers have the information they need to provide the best possible care. We also hope that if we ask the questions – even if patients aren’t ready or willing to share that they have a need – they will know that we are a resource for them.

How We Can Help

If a patient does identify a need, their provider will review that question with them to ensure that their need is understood so that we can put them in touch with the correct resources to help. Most of our practice sites have a care facilitator on staff who can connect patients with community-based resources. We also have community health workers, nurse case managers, and social workers on staff who can assist patients with their needs. Some examples of assistance that we have already provided for our patients include:

  • Coordinating multiple medical appointments to cut down on the number of trips a patient has to make to our office or the hospital
  • Helping patients get on a wait list for affordable housing
  • Providing information on how and where to access food banks
  • Assisting families in obtaining SNAP benefits (food stamps) or getting benefits reinstated if they’ve lost access
  • Arranging transportation to and from medical appointments (if eligible)
  • Help with securing emergency shelter
If a patient isn’t ready to talk, or a need arises in between appointments, we want them to know that they can call us at any time and we can connect them with the resources they need to help make their situation better. Our goal is to partner with our patients to tackle whatever problem that they might face to keep them safe and healthy.
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About The Author

Atrius Health

Atrius Health, an innovative healthcare leader, delivers an effective system of connected care for adult and pediatric patients at more than 30 medical practice locations in eastern Massachusetts. By establishing a solid foundation of shared decision making, understanding and trust with each of its patients, Atrius Health enhances their health and enriches their lives.

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