Three in Four Community Health Centers Are Engaged in Social Determinants of Health Activities. Making These Activities Universal Will Require Greater Investment and Payment Flexibility.

This Data Note examines the extent of community health center involvement in systematic efforts to screen patients for the presence of social determinants of health and concludes that targeted grant support and Medicaid performance investments for the costs associated with social risk screening and reporting are needed for universal engagement by community health centers.

Poverty, lack of safe, affordable housing, hunger and poor nutrition, exposure to domestic violence, and other social conditions all have been shown to deeply affect both short and long term health outcomes. For over five decades, community health centers have been engaged in efforts to identify their patients’ social and health risks and to help fashion responsive solutions. Using information from HRSA’s 2020 nationwide Uniform Data System (UDS), this Data Note examines the extent of community health center involvement in systematic efforts to screen patients for the presence of one or more social determinants of health (SDoH). Based on the reported data, we characterized health centers as being engaged in SDoH activities if the health center reported collecting data on patients’ individual social risk factors, the health center indicated that it utilized one or more standardized social risk screeners, and/or the health center reported any data on the number of patients who screened positive for social risks.