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      Examination of social determinants of health among patients with limited English proficiency

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          Abstract

          Objectives

          The purpose of this study is to examine the prevalence of social needs by English proficiency using data from Northwell Health’s social determinants of health screening program. The screening program evaluates 12 domains of social needs: material need, employment, medical-legal assistance, health insurance, public benefits, health literacy, transportation, medical care, utilities, housing quality, food security, and housing insecurity. We have identified patients to have limited English proficiency if they have selected a language other than English as their primary language.

          Results

          The study population includes 92,958 individuals; of these, 83,445 (89.8%) patients are English proficient, and 9513 (10.2%) patients have limited English proficiency. A higher percentage of patients with limited English proficiency has social needs, including material need, employment, medical-legal assistance, health insurance, public benefit, health literacy, medical care, utility bill, poor housing quality, and food insecurity (all p-values < 0.05). In multivariable logistic regression models adjusting for sociodemographic information, LEP status (odds ratio = 1.36 [1.25–1.49]) has been associated with having social needs. These findings suggest that system-wide SDH screening and referral programs should identify ways to ensure capturing social needs among patients with limited English proficiency.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13104-021-05720-7.

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          Most cited references14

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          The Social Determinants of Health: It's Time to Consider the Causes of the Causes

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            Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

            The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels.
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              Advancing health disparities research within the health care system: a conceptual framework.

              We provide a framework for health services-related researchers, practitioners, and policy makers to guide future health disparities research in areas ranging from detecting differences in health and health care to understanding the determinants that underlie disparities to ultimately designing interventions that reduce and eliminate these disparities. To do this, we identified potential selection biases and definitions of vulnerable groups when detecting disparities. The key factors to understanding disparities were multilevel determinants of health disparities, including individual beliefs and preferences, effective patient-provider communication; and the organizational culture of the health care system. We encourage interventions that yield generalizable data on their effectiveness and that promote further engagement of communities, providers, and policymakers to ultimately enhance the application and the impact of health disparities research.
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                Author and article information

                Contributors
                Afischer1@pride.hofstra.edu
                jconigliaro@northwell.edu
                sallicock@sharpdecisions.com
                ekim7@northwell.edu
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                5 August 2021
                5 August 2021
                2021
                : 14
                : 299
                Affiliations
                [1 ]GRID grid.257060.6, ISNI 0000 0001 2284 9943, Department of Medicine, , Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, ; 500 Hofstra Blvd, Hempstead, NY 11549 USA
                [2 ]GRID grid.250903.d, ISNI 0000 0000 9566 0634, Institute of Health Innovations and Outcomes Research, , Feinstein Institutes for Medical Research, ; 600 Community Drive Suite 403, Manhasset, NY 11030 USA
                [3 ]GRID grid.416477.7, ISNI 0000 0001 2168 3646, Northwell Health, ; 5 Dakota Dr, New Hyde Park, NY 11042 USA
                Author information
                http://orcid.org/0000-0002-4087-5261
                Article
                5720
                10.1186/s13104-021-05720-7
                8340469
                34353369
                bcc3d2b6-7242-4303-a037-560bd31a4a02
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 23 January 2021
                : 29 July 2021
                Categories
                Research Note
                Custom metadata
                © The Author(s) 2021

                Medicine
                social determinants of health,limited english proficiency,health disparities,population health

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