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Table 4 Proposed topics for taking a more complete social history

From: Screening for social determinants of health in clinical care: moving from the margins to the mainstream

1. Individual characteristics

• Self-defined race or ethnicity

• Place of birth or nationality

• Primary spoken language

• English literacy

• Life experiences (education, job history, military service, traumatic or life-shaping experiences)

• Gender identification and sexual practices

2. Life circumstances

• Marital status and children

• Family structure, obligations, and stresses

• Housing environment and safety

• Food security

• Legal and immigration issues

• Employment (number of jobs, work hours, stresses/concerns about work)

3. Emotional health

• Emotional state and history of mental illness (e.g., depression, anxiety, trauma, post-traumatic stress)

• Causes of recent and long-term stress

• Positive or negative social network: individual, family, community

• Religious affiliation and spiritual beliefs

4. Perception of health care

• Life goals & priorities; ranking health among other life priorities

• Personal sense of health or fears regarding health care

• Perceived or desired role for health care providers

• Perceptions of medication and medical technology

• Positive or negative health care experiences

• Alternative care practices

• Advance directives for cardiopulmonary resuscitation

5. Health-related behaviors

• Sense of healthy or unhealthy behaviors

• Facilitators of health promotion (e.g., behaviors among peers)

• Triggers for harmful behaviors and motivation to change (determined through motivational interviewing)

• Diet and exercise habits

• Facilitators or barriers to medication adherence

• Tobacco, alcohol, drug use habits

• Safety precautions: seatbelts, helmets, firearms, street violence

6. Access to and utilization of health care

• Health insurance status

• Medication access and affordability

• Health literacy and numeracy

• Barriers to making appointments (e.g., child care, work allowance, affordability of copayment, transportation)

  1. Adapted from reference [27]