Burden of unmet health-related social needs in an academic adult primary care practice in San Francisco California.

OBJECTIVES: Unmet health-related social needs can influence health outcomes and increase healthcare utilization. There is growing interest in integrating social needs care into healthcare delivery. We conducted an assessment of health-related social needs in an academic adult primary care practice in San Francisco, California. METHODS: We recruited a random convenience sample of adult English-, Chinese- or Spanish-speaking patients from clinic waiting rooms at the study sites to complete a self-administered, anonymous survey. We used the Accountable Health Communities Health-Related Social Needs Screening Tool for these domains: housing instability, food insecurity, transportation problems, utility help needs, interpersonal safety, financial strain, and family/community support. We conducted univariate and multivariate analyses adjusting for age, sex and survey language. RESULTS: 679 patients completed the survey. Respondents were 57% female and mean age of 58 ± 18 years old. 54% of patients had at least one unmet health-related social need. The most prevalent health-related social needs were financial strain (35%), at least one issue with housing conditions (27%), and food insecurity (23%). Respondents completing the survey in Spanish had significantly higher odds of reporting food insecurity (AOR 3.97, 95%CI 1.86, 8.46), transportation problems (AOR 3.13, 95%CI 1.32, 7.43), and need for support with activities of daily living (AOR 4.58, 95%CI 2.04, 10.25) than respondents completing the survey in English. CONCLUSIONS: The burden of unmet health-related social needs was considerable in this adult primary care practice. These findings can support a case for integrating health-related social need screening and social care in the delivery of primary care in the United States to advance health equity.

Demographic trends in social work over a quarter-century in an increasingly female profession.

This article depicts the changing demographic portrait of social work education in the United States from 1974 through 2000 and considers the demographic shifts in the profession of social work. During this period, BSW and joint MSW-BSW programs increased from 150 to 404, MSW programs increased from 79 to 139, and social work doctoral programs increased from 29 to 67. BSW graduates increased by 24 percent to almost 12,000, MSW graduates grew by almost 90 percent to over 15,000, and doctoral graduates increased by 44 percent to only 229. From 1974 to 2000, people of color represented increasing proportions of social work graduates to almost 30 percent of BSW graduates, 26 percent of MSW graduates, and 19 percent of social work PhD graduates. By 2000, the proportion of women earning social work degrees had grown to 88 percent at the BSW, 85 percent at the MSW, and 73 percent at the PhD levels, and women accounted for almost two-thirds of social work faculty. The most dynamic trends within the composition of the profession are the substantial increases in the proportion of women faculty, and among MSW graduates, a decrease in the proportion of men from 43 percent in 1960 to 15 percent in 2000. Findings suggest that issues of racial, ethnic, and gender representation in particular merit discussion within the profession.