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Area of Science:

  • Public Health
  • Health Services Research
  • Social Determinants of Health

Background:

  • The emergency department (ED) is a critical access point for identifying and addressing patients' social risks.
  • A standardized process for social risk screening in the ED is currently lacking.
  • This study addresses the need for a systematic approach to social risk assessment in emergency settings.

Purpose of the Study:

  • To describe the implementation and findings of a social risk screening and resource referral program in an urban academic ED.
  • To evaluate the effectiveness of a comprehensive screening questionnaire in identifying social determinants of health.
  • To analyze demographic associations with the burden of social risk.

Main Methods:

  • Prospective cohort study conducted in a single academic, urban ED from July 2022 to April 2023.
  • Trained staff screened eligible ED patients (aged 18+, medically stable, able to consent) using a 19-question survey covering 12 social determinant domains.
  • Resource referral was facilitated via an online platform or direct social worker contact; data analyzed using univariate logistic regression.

Main Results:

  • Of 1,677 eligible patients, 1,473 (87.8%) consented to screening, and 1,078 (73.2%) reported at least one social risk.
  • The most prevalent risks were social isolation (39%) and depression (23%).
  • High success rates for resource provision were observed for medium (88.9-96.8%) and high (80.8-100%) social risk categories. Female and Black patients showed significantly higher odds of multiple social risks.

Conclusions:

  • A comprehensive social risk screening and referral program was successfully implemented in a large, urban academic ED.
  • Findings highlight the prevalence of social isolation and depression, informing institutional resource prioritization.
  • The developed model offers a framework for other institutions to adapt for their social risk management strategies.