Examination of social determinants of health among patients with limited English proficiency

Abstract

Objectives The purpose of this study is to examine the prevalence of social needs by English proficiency using data from Northwell Health’s social determinants of health screening program. The screening program evaluates 12 domains of social needs: material need, employment, medical-legal assistance, health insurance, public benefits, health literacy, transportation, medical care, utilities, housing quality, food security, and housing insecurity. We have identified patients to have limited English proficiency if they have selected a language other than English as their primary language. Results The study population includes 92,958 individuals; of these, 83,445 (89.8%) patients are English proficient, and 9513 (10.2%) patients have limited English proficiency. A higher percentage of patients with limited English proficiency has social needs, including material need, employment, medical-legal assistance, health insurance, public benefit, health literacy, medical care, utility bill, poor housing quality, and food insecurity (all p-values < 0.05). In multivariable logistic regression models adjusting for sociodemographic information, LEP status (odds ratio = 1.36 [1.25–1.49]) has been associated with having social needs. These findings suggest that system-wide SDH screening and referral programs should identify ways to ensure capturing social needs among patients with limited English proficiency.

A Multicenter Retrospective Evaluation of Social Determinant of Health Z Code Usage among Pediatric Patients with Critical Care Visits during Pediatric Critical Care

“…46 Finally, language barriers may limit screening and contribute to a lower percentage of SDOH Z code documentation for Hispanic and Latino populations. 47 This finding may suggest that factors such as ethnicity may influence whether clinicians screen for and document Z codes. Overall, this highlights the importance of screening for and documenting Z codes at the same frequency and in the same manner for all patients no matter the challenges or barriers that are present.…”

Social determinants and health‐related quality of life in a sample of diverse, low socioeconomic status cancer patients

“…Increased risk of poor FWB for the LEP and the unemployed could be due to social determinants of health, such as material needs (e.g., childcare, utilities, transportation, and housing), precarious employment, medical‐legal assistance needs (e.g., insurance, immigration documentation, custody, or child support), and food insecurity 39 . When faced with a cancer diagnosis, which increases the complexity and burden of these needs, everyday functioning may suffer.…”

Transcending Language Barriers in Obstetrics and Gynecology

“…[52][53][54][55] A large cohort study comparing SDOH screening results between English-speaking patients and patients with LEP demonstrated significantly higher social needs among patients with LEP in almost all of the dimensions queried, including material needs, employment, and food insecurity. 56 Furthermore, Spanish-speaking patients had higher needs across all domains when compared with the population with LEP as a whole. 56 ACOG Committee Opinion No.…”

“…56 Furthermore, Spanish-speaking patients had higher needs across all domains when compared with the population with LEP as a whole. 56 ACOG Committee Opinion No. 729 describes the role of SDOH in reproductive health care and provides recommendations to obstetrician-gynecologists for addressing inequities.…”