Which topics should CHWs ask about during a client encounter to identify social determinants of health?

• A. Housing, transportation, food access, safety, and social support; identify barriers and connect to resources.
• B. Only medical history and medications.
• C. Insurance status alone determines access to care.
• D. Weather patterns are the primary determinant.

Answer: (A)

Understanding social determinants of health means focusing on the living conditions and supports that shape a person’s health, not just clinical factors. The topics of housing, transportation, food access, safety, and social support are central because they influence a person’s ability to access care, follow through with treatments, and maintain well-being. For example, unstable housing can make storing medications or keeping follow-up appointments difficult; lack of transportation can prevent going to visits; food insecurity affects nutrition and energy; unsafe neighborhoods add stress and barriers to activity or seeking help; and strong social support can provide practical help and encouragement. By asking about these areas, a CHW can identify real barriers and link the client to resources such as housing assistance, transportation options, food programs, safety planning, and community supports, which helps remove obstacles to care and improve health outcomes.

Other choices miss important parts of what shapes health. Medical history and medications focus on clinical needs but not the social context; insurance status alone explains access to care only in part and misses day-to-day barriers; weather patterns aren’t the primary determinants addressed in routine SDOH screening.