Bridging the health gap: Measuring the unmet social needs of patients within a dental school clinic

Objectives: As safety-net clinics, dental school clinics are uniquely positioned to evaluate the unmet social need. There is evidence that patients treated in a safety-net type clinic, such as dental schools, report experiencing one or more of the determinants of health. However, there is limited evidence describing screening for Social Determinants of Health (SDOH) in dental clinics. The purpose of this study is to gain knowledge of the types of social determinants of health that exist in a dental school clinic and how it is reflected in the geographic region of the school. Methods: This cross-sectional prospective study used a 20-item questionnaire assessed unmet social needs in a predoctoral clinic. The questionnaire contained multiple choice and binary yes/no questions, organized under SDOH domains: housing, food, transportation, utilities, childcare, employment, education, finances, and personal safety. Socioeconomic and demographic information was captured. The questionnaire was administered via iPad using Qualtrics XM. The data were descriptively and quantitatively analyzed at a significance level of p ≤ 0.05. Results: There were 175 respondents with a 93.6% response rate, males (49.7%), females (49.1%), and 1.1% nonbinary. Overall, 135 (77.1%) respondents reported having at least one unmet social need. The greatest number of unmet needs was in the domains of employment and finances, with 44% and 41.7% respectively. Respondents who were unable to work stated they often or sometimes worried about running out of food before getting money to buy more, (p = 0.0002), and or the food didn't last before there was money to get more (p = 0.00007). A comparison of annual incomes of respondents earning less than $40K with those earning $40K or more, demonstrated statistically significant differences in unmet social needs for housing (p < 0.0001), food (p = 0.0003, p < 0.0001), utilities (p = 0.0484), employment (p = 0.0016), education (p < 0.0001), and finances (p < 0.0001). Conclusion: Screening patients in the dental clinic was an efficient way to uncover the level of unmet social needs. Annual household income was a predominant driver of unmet social needs: with the greatest number of unmet needs existing in the domains of employment and finances. The results suggest that screening for social determinants of health dental school clinics could be incorporated into routine patient data collection.