Lauren A. Walter|Elizabeth Schoenfeld|Kay Hogan Smith|Erin F Shufflebarger|Charles Khoury|Katherine Baldwin|Jennifer J. Hess|Matthew A. Heimann|Cameron Crosby|Sylvia Y Sontheimer|Stephen Gragg|Delissa T. Hand|Joseph S. McIlwain|Christopher J. Greene|Rachel M. Skains|Erik P. Hess
Emergency department–based interventions affecting social determinants of health in the United States: A scoping review
University of Alabama at Birmingham|Baystate Medical Center|University of Massachusetts Chan Medical School|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|Vanderbilt University Medical Center|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|Christiana Care Health System|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|University of Alabama at Birmingham|Vanderbilt University Medical Center
abstract background social determinants health sdoh significant implications health outcomes united states emergency departments eds function safety nets american health care system caring many vulnerable populations edbased interventions assess social risk mitigate social needs reported literature however breadth scope interventions evaluated field social emergency medicine sem expands mapping categorization previous interventions may help shape future research sought identify summarize characterize edbased interventions aimed mitigating negative sdoh methods conducted scoping review identify characterize peerreviewed research articles report edbased interventions address impact sdoh united states designed conducted search medline cinahl cochrane central databases abstracts subsequently full articles reviewed independently two reviewers identify potentially relevant articles included articles categorized type intervention primary sdoh domain reported outcomes also categorized type efficacy results total 10856 abstracts identified reviewed 596 potentially relevant studies identified full article review identified 135 articles inclusion articles subdivided three intervention types provider educational intervention 18 b disease modification sdoh focus 26 c direct sdoh intervention 60 4 including two types articles subsequently grouped seven sdoh domains 1 access care 33 2 discriminationgroup disparities 7 3 exposure violencecrime 34 4 food insecurity 2 5 housing issueshomelessness 3 6 languageliteracyhealth literacy 12 7 socioeconomic disparitiespoverty 10 majority articles reported intervention studied effective primary outcome identified 78 conclusion emergency departmentbased interventions address seven different sdoh domains reported peerreviewed literature past 30 years utilizing variety approaches including provider education direct indirect focus social risk need characterization understanding previous interventions may help identify opportunities future interventions well guide sem research agenda