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Social Health Surveillance: A Systematic Review

Context: Health service providers increasingly screen for health-related social risks and refer patients to social care resources. However, a national, individual-level social health surveillance system that supports this linkage between medical and social care does not yet exist. Public health surveillance provides the model for a national, individual-level social health surveillance system specifically designed to support the integration of social and medical care in order to address upstream contributors of illness. Objective: To systematically review the literature describing existing social health surveillance systems in the United States that screen, address, collect, store, analyze, and disseminate social needs or risk factors for the purposes of developing activities that impact population health. Design: Articles from PubMed, MEDLINE, and Social Intervention Research and Evaluation Network (SIREN) Evidence Library between January 1, 2008 and December 31, 2018 were searched using the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P). Eligibility Criteria: Epidemiological surveillance was used as a model to identify social health surveillance systems, defined as the ongoing collection, storage, analysis, and classification of social determinants of health data essential to the planning, implementation, and evaluation of interventions intended to improve health outcomes. Study Selection: Thirteen articles met the inclusion and exclusion criteria, representing 9 different social health surveillance systems serving mostly low-income populations in 20 states. Main Outcome Measures: The social health surveillance systems integrate social and medical care to improve health outcomes. Results: All 9 social health surveillance systems continuously collected individual-level social determinants of health data from at least 2 of the 17 domains recommended by the Institute of Medicine. A wide variation existed in the social health surveillance systems capabilities. Discussion: To build a 21 st century social health surveillance system, public health leaders should expand epidemiological surveillance in collaboration with the medical and social care systems to include individual level social determinants of health.