Article Figures & Data
Figures
- Figure 1.
Desire for assistance among respondents who endorsed 1 or more social risk.
Tables
Patient Factors Overall (N = 438) Any Social Risk (n = 212) No Social Risk (n = 225) P Value Sociodemographics
Age category, No. (%), y18-26 84 (19.2) 48 (22.5) 36 (16.0) .24 27-44 107 (24.4) 52 (24.4) 55 (24.4) 45-61 89 (20.3) 37 (17.4) 52 (23.1) ≥62 158 (36.1) 76 (35.7) 82 (36.4) Sex, No. (%) Female 246 (56.2) 127 (59.6) 109 (52.9) .16 Male 192 (43.8) 86 (40.4) 106 (47.1) Race/Ethnicity, No. (%) American Indian, Alaska Native 3 (0.8) 0 (0.0) 3 (1.6) Asian, Pacific Islander 56 (15.6) 29 (17.1) 27 (14.4) Non-Hispanic Black, African American 14 (3.9) 10 (5.9) 4 (2.1) .16 Hispanic, Latino 114 (31.8) 57 (33.5) 57 (30.3) Non-Hispanic, Multiple 5 (1.4) 3 (1.8) 2 (1.1) Non-Hispanic White 166 (46.4) 71 (41.8) 95 (50.5) Missing 80 (18.3) 43 (20.2) 37 (14.2) Preferred spoken language, No. (%) English 368 (84.0) 175 (82.2) 193 (85.8) .30 Spanish 70 (16.0) 38 (17.8) 32 (14.2) Duration KP membership, No. (%), y <1 109 (24.9) 63 (29.6) 46 (20.4) .10 1-2 138 (31.5) 69 (31.9) 70 (31.1) 3-4 100 (22.8) 43 (20.2) 57 (25.3) ≥5 91 (20.8) 39 (18.3) 52 (23.1) Education (census tract) Percent with <12 years, mean (SD) median 16.7 (13.9) 18.3 (15.1) 15.1 (12.5) .059 12.3 13.8 11.2 Neighborhood Deprivation Index, mean (SD) median 0.08 (0.95) 0.19 (1.01) -0.02 (0.89) .042 –0.14 –0.07 –0.20 Self-reported health, No. (%) Excellent/Very good/Good 368 (84.8) 166 (79.1) 202 (90.2) .001 Fair/Poor 66 (15.2) 44 (21.0) 22 (9.8) Missing 4 (0.0) 3 (0.0) 1 (0.0) Attitudes, No. (%) Trust in clinician Complete (10) 124 (29.0) 48 (23.5) 76 (33.9) .06 High (8-9) 172 (40.2) 89 (43.6) 83 (37.1) Medium-Low (1-7) 132 (30.8) 67 (32.8) 65 (29.0) Missing 10 (2.3) 9 (4.2) 1 (0.4) Health care–based social risk screening Very/Somewhat appropriate 265 (61.2) 129 (61.1) 136 (61.3) .78 Neither appropriate nor inappropriate 104 (24.0) 53 (25.1) 51 (23.0) Very/Somewhat inappropriate 64 (14.8) 29 (13.7) 35 (15.8) Missing 5 (1.1) 2 (0.9) 3 (1.3) Uncomfortable with social risk screening No 393 (90.3) 181 (85.8) 212 (94.6) .002 Yes 42 (9.7) 30 (14.2) 12 (5.4) Missing 3 (0.7) 2 (0.9) 1 (0.4) Role of health care to help with basic needs Health care has a role 390 (89.7) 190 (90.1) 200 (89.3) .79 Health care has no role 45 (10.3) 21 (10.0) 24 (10.7) Missing 3 (0.7) 2 (0.9) 1 (0.4) Role of health care: knowing a person is struggling with basic needs No 242 (55.6) 111 (52.6) 131 (58.5) .22 Yes 193 (44.4) 100 (47.4) 93 (41.5) Missing 3 (0.7) 2 (0.9) 1 (0.4) Role of health care: connecting people with resources in the community No 218 (50.1) 103 (48.8) 115 (51.3) 0.60 Yes 217 (49.9) 108 (51.2) 109 (48.7) Missing 3 (0.7) 2 (0.9) 1 (0.4) Role of health care: offering care aligned with a person’s needs No 242 (55.6) 111 (52.6) 131 (58.5) .23 Yes 193 (44.4) 100 (47.4) 93 (41.5) Missing 3 (0.7) 2 (0.9) 1 (0.4) Role of health care: fund community program to help with basic needs No 308 (70.8) 143 (67.8) 165 (73.7) .18 Yes 127 (29.2) 68 (32.2) 59 (26.3) Missing 3 (0.7) 2 (0.9) 1 (0.4) KP = Kaiser Permanente.
Risk No. (%) 95% CI Any risk 212 (48.6) 43.95-53.31 Housing instability 150 (34.2) 29.80-38.69 Food insecurity (1 missing) 105 (24.0) 20.02-28.03 Utility services issue 30 (6.8) 4.48-9.22 Lack of transportation 41 (9.4) 6.63-12.09 - Table 3.
Adjusted Associations Between Patient Factors and Having a Social Risk and a Desire for Assistance With the Social Risks
Having a Social Risk Factor Desire for Assistance Conditional on Social Risk Factor Patient Factors RR 95% CI P Value RR 95% CI P Value Age Category, y 18-26 Ref .26 Ref .61 27-44 0.86 0.64-1.15 1.22 0.67-2.22 45-61 0.73 0.54-0.99 1.50 0.80-2.83 ≥62 0.86 0.66-1.13 1.05 0.58-1.90 Sex Male Ref .12 Ref .60 Female 1.17 0.96-1.43 0.90 0.60-1.34 Race/Ethnicity White only Ref .49 Ref .15 Black, African American only 1.59 1.07-2.38 2.23 1.29-3.84 Hispanic, Latinoa 0.95 0.71-1.28 1.44 0.76-2.75 Otherb 1.04 0.76-1.42 1.36 0.68-2.73 Missing 0.99 0.72-1.35 0.91 0.45-1.83 Percent with <12 years education <5% Ref .33 Ref .71 5-9% 1.14 0.83-1.58 1.15 0.56-2.37 10-14% 1.18 0.82-1.69 0.73 0.31-1.68 15-19% 1.11 0.76-1.63 1.31 0.66-2.60 20-24% 1.04 0.73-1.50 1.17 0.57-2.41 25-29% 1.60 1.04-2.48 0.77 0.29-2.01 30-34% 1.04 0.58-1.86 2.26 0.80-6.43 ≥35% 1.48 1.05-2.09 1.08 0.50-2.30 Preferred spoken language English Ref .89 Ref .72 Spanish 1.02 0.76-1.37 0.90 0.51-1.58 Duration KP membership, y ≥5 Ref .09 Ref .57 <1 1.44 1.07-1.94 1.34 0.74-2.44 1-2 1.15 0.86-1.55 0.96 0.51-1.84 3-4 1.08 0.78-1.50 1.18 0.59-2.38 Self-reported health Excellent/Very good/Good Ref .001 Ref .37 Fair/Poor 1.54 1.24-1.92 1.24 0.79-1.96 Trust in clinician Complete (10) Ref .01 Ref .13 High (8-9) 1.47 1.13-1.90 0.92 0.52-1.64 Medium-Low (1-7) 1.29 0.98-1.70 1.47 0.83-2.61 Health care–based social risk screening Very/Somewhat appropriate Ref .82 Ref .05 Neither appropriate nor inappropriate 0.97 0.71-1.32 0.45 0.21-0.97 Very/Somewhat inappropriate 1.07 0.84-1.35 0.68 0.40-1.16 Uncomfortable with social risk screening No Ref .01 Ref .48 Yes 1.57 1.20-2.04 1.23 0.71-2.10
SUPPLEMENTAL MATERIALS IN PDF FILE BELOW
- TuzzioSupp.pdf -
Supplemental Table 1. Survey measures, items, and response categories
Supplemental Table 2. Risk domain by comfort being screened
- TuzzioSupp.pdf -
VISUAL ABSTRACT IN PDF BELOW
- Tuzzio_visualabstract.png -
Do patients facing heightened instability in high poverty contexts want assistance from their health care providers? Surveyed patient perspectives on clinic-level screening for, and assistance with, basic social needs
- SocialRisks.pdf -
Kaiser Permanent Washington Health Research Institute promotional video for this article
- Tuzzio_visualabstract.png -
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