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Birmingham health links: addressing social determinants of health in the clinical setting

Sloan, Jennifer (2014) Birmingham health links: addressing social determinants of health in the clinical setting. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background A recent body of evidence suggests that addressing social determinants of health in the clinical setting improves health status and helps reach health targets, a topic of important public health significance. The Birmingham Free Clinic (BFC) in Pittsburgh’s South Side recently implemented Birmingham Health Links (BHL), a program to address patient’s social determinants of health. With nearly half of Birmingham patients considered homeless and over 90% living below the federal poverty level, BFC serves some of the city’s most vulnerable.
Program Description BHL is a social services help desk modeled after Health Leads, Inc that trains student volunteers to help patients address the broader social factors that influence health such as employment, food security and housing. Students engage with patients one-on-one to understand their situation, create an individualized action plan and follow-up on a weekly basis by phone until the patients’ needs are met to the patient’s satisfaction.
Methods A program evaluation included an analysis of patient case files, a patient phone survey using the Client Satisfaction Questionnaire-8 (CSQ-8), and a qualitative analysis of students’ weekly reflections.
Results During the first 6 months of the program, 23% of unique clinic patients used the BHL help desk. The top three needs were housing assistance (26%), food assistance (18%) and employment (16%). Twenty percent of cases (n=80) were closed because needs were met and 59% were lost to follow up after the initial encounter. The phone survey (n=14) found that patients were quite satisfied with their experience. The analysis of student reflections (n=166) found that many students noted personal and professional growth, a new understanding and appreciation for social determinants of health and a shift in their career path to include work with underserved populations as a result of this experience.
Conclusion This model of addressing social determinants of health in a clinical setting shows great promise for being welcomed by patients, for providing future health professionals with an applied understanding of the importance of social determinants on health and shows feasibility due to it’s low annual budget.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBurke, Jessicajgburke@pitt.eduJGBURKE
Committee MemberRicci, Edmundemricci@pitt.eduEMRICCI
Committee MemberFoster, Lovieljj10@pitt.eduLJJ10
Committee MemberHerbert,
Date: 27 June 2014
Date Type: Publication
Defense Date: 27 March 2014
Approval Date: 27 June 2014
Submission Date: 7 April 2014
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 53
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: social determinants of health;
Date Deposited: 27 Jun 2014 22:35
Last Modified: 15 Nov 2016 14:18


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