Social determinants of health in primary care

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Published: 8 Jul 2023
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Dr Jennifer Goldman - Memorial Healthcare System, Florida, USA

Dr Jennifer Goldman speaks to ecancer about the social determinants of health in primary care. Social determinants of health are factors that influence the health of patients outside of medicine. She discusses why highlighting these factors are important in screening and cancer care and how community resources can be best utilised.

Somebody who is dealing with a chronic condition needs a lot of support for what they’re dealing with. Thus, at the Memorial Healthcare System, these factors are integrated into the screening process so better support services can be integrated to help patients.

Dr Goldman discusses the programme that was rolled out at the Memorial Healthcare System for screening universally for social determinants of health in primary care and what it found.



What was your talk/moderation about?

Social determinants of health are factors that influence your health outside of medicine. So think about where you live, where you work, where you go to school or where you worship and whether or not you have sufficient resources to take care of yourself and your family because if you don’t we know that that can negatively impact your health. When you’re suffering with a disease such as cancer, we really want to make sure that we are not only asking you about any barriers you have to treatment for the cancer but that we’re helping connect you with community resources so that at the end of the day you can focus on getting better with the cancer and we can help you with items such as food, even housing or even socialisation. We know that somebody dealing with a chronic condition needs a lot of socialisation, a lot of support for what they’re dealing with. So we believe that it’s really important to integrate these items into screening and really just welcoming every patient that comes through Memorial Healthcare System.

Could you provide an overview of the comprehensive cancer care services available at Memorial Cancer Institute?

We rolled out screening universally for social determinants of health in primary care. I’m the Chief of Primary Care at Memorial Healthcare System and the Chief Medical Information Officer and we rolled out screening for social determinants of health a year ago. We did that for everybody coming through our practices every visit and what we found is that in a year we were able to document over 4,000 social determinants of health that our patients were dealing with. So that means, again, access to food, access to transportation, access to housing, whether or not utilities are impacted because you can’t pay your bills or whether or not there’s violence in your home or if you’re struggling with something else.

Not only did we identify them, we were able to link people with resources that are available in our communities. We found that doing so helped our patients become more engaged, basically, keep their follow-up appointments, make sure that they were more adherent to the medicines that we gave them because we were listening to them as a whole person and not just as a collection of their conditions.

Can you please tell us about your role at Memorial Cancer Institute? 

I’m a family physician so not traditionally in the cancer centre but certainly my role at Memorial is at the system level as the Chief Medical Information Officer. As such, I try to help all of our physicians and our oncologists, of course, with really integrating doing the right thing from a documentation standpoint with their workflow. So basically making it easier for people to do their jobs, making it easier for doctors to talk to people, talk to patients without having to do so much on the computer. 

So I work on that and, at the same time, since I’m a family physician and I practice at Memorial, I help to coordinate those follow-up visits that patients need when they are finished with their cancer treatment with a family doctor, an internal medicine primary care doctor, so that they always have somebody looking out for them whether they are sick or whether they are well.