Community Needs and SDOH Flashcards

Which SDOH domain directly encompasses a patient's inability to afford prescription medications?

Answer: Economic stability

Economic stability covers financial resources including income, employment, and ability to afford medications and basic needs.

A community paramedic visits an elderly patient living alone who rarely leaves home due to mobility limitations. This patient is most at risk for which SDOH-related condition?

Answer: Social isolation and depression

Homebound elderly patients with limited social contact are at high risk for social isolation, which is strongly linked to depression and poor health outcomes.

When conducting a community health needs assessment (CHNA), which data source is MOST useful for identifying neighborhood-level health disparities?

Answer: Census and demographic data

Census and demographic data provide population-level insights on income, education, housing, and race that reveal neighborhood health disparities.

A community paramedic screens a 45-year-old patient using the PRAPARE tool. The patient reports unstable housing. The FIRST appropriate action is to:

Answer: Refer to an emergency shelter resource

Unstable housing is an immediate social need; the first response is to connect the patient with appropriate community resources such as emergency shelter.

Food insecurity is classified under which of the five key SDOH domains identified by Healthy People 2030?

Answer: Economic stability

Food insecurity falls under the Economic Stability domain because access to adequate food is directly tied to income and financial resources.

Which screening instrument is specifically designed to assess social determinants of health in clinical settings for the community paramedic?

Answer: PRAPARE (Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences)

PRAPARE is a standardized SDOH screening tool used by health workers, including community paramedics, to assess social risks and connect patients to resources.

A community paramedic notes that a large portion of their service area lacks reliable public transportation. This observation relates primarily to which SDOH domain?

Answer: Neighborhood and built environment

Transportation access is part of the Neighborhood and Built Environment domain, which includes physical infrastructure affecting residents' ability to access services.

The 'life course perspective' in community health suggests that health disparities are best addressed by:

Answer: Intervening at critical developmental stages across a person's lifespan

The life course perspective emphasizes that early exposures and experiences compound over time, so interventions at key developmental stages yield the greatest long-term health benefits.

Which of the following BEST defines 'health equity' in the context of community paramedicine?

Answer: Ensuring every person has a fair opportunity to attain their highest level of health

Health equity means removing avoidable barriers so that each person has a fair chance to achieve optimal health, acknowledging that different people may need different support.

A community paramedic is conducting home visits in a predominantly Spanish-speaking neighborhood. The MOST important action to ensure effective SDOH screening is to:

Answer: Use a professionally interpreted or translated screening tool

Professionally interpreted or translated tools ensure accurate screening results and respect for language as a social determinant of healthcare access.

When assessing 'adverse childhood experiences' (ACEs), a community paramedic is evaluating risk factors in which SDOH domain?

Answer: Social and community context

ACEs—including abuse, neglect, and household dysfunction—are social and relational factors captured under the Social and Community Context domain.

Which population is at HIGHEST risk for poor health outcomes directly linked to residential segregation?

Answer: Racial and ethnic minorities concentrated in under-resourced urban areas

Residential segregation concentrates racial and ethnic minorities in neighborhoods with fewer resources, higher pollution exposure, and less access to quality health care, driving disparate outcomes.

A community paramedic identifies that many patients in their catchment area have limited health literacy. Which approach is MOST effective when providing patient education?

Answer: Use teach-back methods and plain language materials

Teach-back combined with plain language materials confirms patient understanding and is the evidence-based approach for patients with limited health literacy.

Social cohesion—the level of trust and connectedness within a neighborhood—is MOST closely linked to which health outcome?

Answer: Reduced violence and improved mental health outcomes

Strong social cohesion is associated with reduced violence, lower crime rates, and better mental health because community trust creates protective social networks.

A community paramedic is part of a team evaluating why diabetes prevalence is disproportionately high in one ZIP code. The BEST systems-level approach is to:

Answer: Conduct a root-cause analysis examining upstream SDOH factors

Root-cause analysis examines upstream SDOH factors (food access, income, education) rather than only addressing downstream clinical symptoms.

Which of the following is the BEST example of a 'upstream' social determinant intervention for reducing asthma hospitalizations?

Answer: Advocating for housing code enforcement to reduce indoor allergens

Housing code enforcement addresses the root cause—substandard housing with mold and pests—rather than managing the downstream clinical consequence.

A community paramedic program wants to evaluate its impact on reducing preventable ED visits. Which metric is MOST appropriate?

Answer: 30-day ED revisit rates among enrolled patients

30-day ED revisit rates directly measure whether the program successfully prevents unnecessary emergency department use among its target patients.

A patient reports they cannot attend follow-up appointments because they have no car and the nearest bus stop is a mile away. This is an example of a barrier in which SDOH domain?

Answer: Neighborhood and built environment

Transportation infrastructure and proximity to services are features of the Neighborhood and Built Environment domain that directly affect healthcare access.

In the community paramedicine model, 'warm handoffs' to social service agencies PRIMARILY serve to:

Answer: Ensure continuity of care and increase the likelihood the patient follows through on referrals

Warm handoffs—direct, real-time introductions to service providers—dramatically improve referral completion rates compared to giving a patient a phone number.

Which of the following BEST illustrates the concept of 'structural racism' as a social determinant of health?

Answer: Historical redlining policies that concentrated poverty in predominantly minority neighborhoods

Structural racism refers to policies and systems—like historical redlining—that produce racially inequitable outcomes by design, independent of individual attitudes.