P. Podugu1, A. Mahajan1, A.Y. Mo2, M.J. Kalina1, S.A. Sweeney1,2, P. Mallu2, Y. Hu2, V.P. Ho1,2 1MetroHealth Medical Center, Department Of Surgery, Cleveland, OH, USA 2Case Western Reserve University School Of Medicine, Cleveland, OH, USA
Introduction:
Trauma patients are known to have disproportionately higher risk along multiple axes of social need including housing instability, food insecurity, transportation needs, and others. Less is understood about the role of traumatic injury in shaping these social drivers of health (SDOH). We hypothesized that traumatic injury would be associated with increased SDOH needs and risk across multiple domains.
Methods:
We identified patients in our 2022 trauma registry who completed a hospital-administered self-reported SDOH screen within one year before and after their traumatic event. The SDOH screen assessed risk across eleven domains including food, housing, transportation, digital connection, and overall stress; risk was categorized as “At Risk” or “Not At Risk.” We assessed changes in SDOH risk pre- and post-trauma across each domain. We then used McNemar paired testing to assess the significance of changes.
Results:
118 patients met our inclusion criteria (median age 68; 62% male; 59% white and 31% Black). Most patients experienced either decreased or no change in SDOH risk for nearly all domains (Figure 1). Results are reported as percentages of the total number of patients in each domain who had reported a risk level prior to their trauma. A majority or near-majority of patients experienced decreased risk for food insecurity (55%) and housing stability (47%). Most patients did not experience a change in risk level in the domains of financial strain, physical activity, social connection, and daily stress. Although 55% of patients screened noted decreased risk of food insecurity, 27% noted increased risk of food insecurity.
Conclusion:
These findings suggest that traumatic injury and subsequent healthcare engagement represent an opportunity to meaningfully intervene on the social needs of patients. Most patients experienced a decrease in self-reported risk for food insecurity and housing after their trauma—areas which are specifically targeted by the social work and trauma recovery service providers at our hospital. However, many patients noted no change in risk in multiple other domains. Future efforts must allocate resources to continue to appropriately address these persistent social needs of our patients after traumatic injury.