How would you assess and address social determinants of health in a primary care encounter?

• A. Screen for housing, nutrition, safety, transportation, and income; connect to community resources; document and monitor.
• B. Ignore social determinants and focus on biomedical factors only.
• C. Assume determinants are the same for all patients.
• D. Refer all patients to social workers regardless of need.

Answer: (A)

Assessing social determinants in a primary care encounter means actively looking for factors outside medical symptoms that influence health, such as housing, nutrition, safety, transportation, and income, and then acting on them. The best approach involves three linked steps: screen for these needs, connect the patient with appropriate community resources, and document and monitor the impacts as part of the care plan. Screening helps uncover barriers that can affect access to medications, follow-up appointments, and the ability to follow treatment recommendations. Connecting patients to resources—like housing assistance, food programs, transportation support, or financial counseling—addresses these barriers directly so medical care can be effective. Documentation and ongoing monitoring ensure that issues are tracked over time, progress is evaluated, and adjustments are made at follow-up visits.

This approach is superior because it recognizes that health is shaped by living conditions and supports patients in practical ways to improve outcomes. By contrast, ignoring social determinants misses critical barriers; assuming every patient has the same needs overlooks individual circumstances; and referring every patient to social work regardless of need is inefficient and may not provide targeted help where it’s truly needed.