As experience with social risk interventions matures, and federal and state agencies consider ways to incentivize social risk interventions, this is an ideal time to pause and ask whether we are going in the right direction with this work. In this perspective piece, the authors highlight that the focus on social risk screening and referrals rests on the assumptions: (1) that patients do not already know how to access resources; and (2) that resources to address patients’ needs are readily available. However, there is little evidence to support these assumptions. In fact, many patients are already aware of resources, and the underfunded safety net in the United States does not fully provide the resources needed to address patients’ needs. Furthermore, many patients are reluctant to seek help because of the shame and stigma associated with needing help in our society. In this context, screening and referring will provide limited benefits. The authors therefore recommend that health care organizations focus on better understanding the realities facing low-income patients and work with patients and social service experts to identify how health care organizations can best help to address patients’ needs as well as the community conditions in which patients live. Ultimately, if the health care sector is genuine in its belief that improving health involves addressing social risk factors, it must invest in interventions that are commensurate with and responsive to the needs and challenges facing patients and communities.
Caroline Fichtenberg and Taressa K. Fraze have nothing to disclose.
NEJM Catalyst Innovations in Care Delivery
Copyright © 2023 Massachusetts Medical Society.
Published online: March 15, 2023
Published in issue: March 15, 2023
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