CPC Community Needs and SDOH 2 — Questions and Answers

Question 1: Which SDOH domain directly encompasses a patient's inability to afford prescription medications?

Economic stability (Correct answer)
Education access
Health care access
Neighborhood environment

Correct answer: Economic stability

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

Question 2: 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?

Hypertension from poor diet
Social isolation and depression (Correct answer)
Occupational hazard exposure
Lack of health insurance

Correct 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.

Question 3: When conducting a community health needs assessment (CHNA), which data source is MOST useful for identifying neighborhood-level health disparities?

Individual patient chief complaints
Census and demographic data (Correct answer)
Hospital discharge diagnoses only
Physician referral patterns

Correct answer: Census and demographic data

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

Question 4: A community paramedic screens a 45-year-old patient using the PRAPARE tool. The patient reports unstable housing. The FIRST appropriate action is to:

Document and close the encounter
Refer to an emergency shelter resource (Correct answer)
Notify law enforcement
Recommend the patient purchase a home

Correct 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.

Question 5: Food insecurity is classified under which of the five key SDOH domains identified by Healthy People 2030?

Health care access and quality
Economic stability (Correct answer)
Social and community context
Education access and quality

Correct answer: Economic stability

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

Question 6: Which screening instrument is specifically designed to assess social determinants of health in clinical settings for the community paramedic?

GCS (Glasgow Coma Scale)
PRAPARE (Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences) (Correct answer)
PHQ-9 (Patient Health Questionnaire)
AUDIT-C (Alcohol Use Disorders Identification Test)

Correct 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.

Question 7: A community paramedic notes that a large portion of their service area lacks reliable public transportation. This observation relates primarily to which SDOH domain?

Social and community context
Neighborhood and built environment (Correct answer)
Economic stability
Education access and quality

Correct 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.

Question 8: The 'life course perspective' in community health suggests that health disparities are best addressed by:

Treating acute illness only when it presents
Intervening at critical developmental stages across a person's lifespan (Correct answer)
Focusing solely on elderly populations
Prioritizing hospital-based interventions

Correct 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.

Question 9: Which of the following BEST defines 'health equity' in the context of community paramedicine?

Equal distribution of medical equipment to all neighborhoods
Ensuring every person has a fair opportunity to attain their highest level of health (Correct answer)
Providing identical care to all patients regardless of need
Reducing total healthcare spending across a community

Correct 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.

Question 10: A community paramedic is conducting home visits in a predominantly Spanish-speaking neighborhood. The MOST important action to ensure effective SDOH screening is to:

Conduct all screenings in English to maintain consistency
Use a professionally interpreted or translated screening tool (Correct answer)
Skip the screening if a translator is unavailable
Have the patient's child interpret for them

Correct 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.

Question 11: When assessing 'adverse childhood experiences' (ACEs), a community paramedic is evaluating risk factors in which SDOH domain?

Neighborhood and built environment
Social and community context (Correct answer)
Economic stability
Health care access and quality

Correct 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.

Question 12: Which population is at HIGHEST risk for poor health outcomes directly linked to residential segregation?

Rural white adults over 65
Racial and ethnic minorities concentrated in under-resourced urban areas (Correct answer)
Suburban middle-income families
College-educated young adults in urban cores

Correct 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.

Question 13: A community paramedic identifies that many patients in their catchment area have limited health literacy. Which approach is MOST effective when providing patient education?

Distribute printed materials written at a college reading level
Use teach-back methods and plain language materials (Correct answer)
Refer all patients with low literacy to specialists
Avoid written materials entirely and rely on verbal instruction only

Correct 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.

Question 14: Social cohesion—the level of trust and connectedness within a neighborhood—is MOST closely linked to which health outcome?

Decreased rates of chronic obstructive pulmonary disease
Reduced violence and improved mental health outcomes (Correct answer)
Lower incidence of congenital disorders
Decreased rates of occupational injury

Correct 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.

Question 15: 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:

Increase individual patient counseling sessions only
Conduct a root-cause analysis examining upstream SDOH factors (Correct answer)
Prescribe more insulin to affected residents
Reduce 911 response times in the area

Correct 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.

Question 16: Which of the following is the BEST example of a 'upstream' social determinant intervention for reducing asthma hospitalizations?

Prescribing additional rescue inhalers
Advocating for housing code enforcement to reduce indoor allergens (Correct answer)
Teaching inhaler technique at every visit
Increasing specialist referrals

Correct 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.

Question 17: A community paramedic program wants to evaluate its impact on reducing preventable ED visits. Which metric is MOST appropriate?

Number of 911 calls received per month
30-day ED revisit rates among enrolled patients (Correct answer)
Average response time to emergencies
Total number of community paramedic home visits made

Correct 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.

Question 18: 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?

Economic stability
Neighborhood and built environment (Correct answer)
Social and community context
Education access and quality

Correct 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.

Question 19: In the community paramedicine model, 'warm handoffs' to social service agencies PRIMARILY serve to:

Reduce the community paramedic's documentation burden
Ensure continuity of care and increase the likelihood the patient follows through on referrals (Correct answer)
Eliminate the need for follow-up home visits
Transfer clinical liability to the receiving agency

Correct 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.

Question 20: Which of the following BEST illustrates the concept of 'structural racism' as a social determinant of health?

A provider using biased language during a clinical encounter
Historical redlining policies that concentrated poverty in predominantly minority neighborhoods (Correct answer)
A patient's personal beliefs about health and illness
Individual provider implicit bias during diagnosis

Correct 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.

Question 21: A community paramedic uses the WE CARE screening tool during a pediatric home visit. The WE CARE tool is designed to identify:

Domestic violence risk in adult women
Social needs in families with young children including food, housing, and employment (Correct answer)
Elder abuse in patients over 65
Mental health crisis severity in adolescents

Correct answer: Social needs in families with young children including food, housing, and employment

WE CARE is a validated social needs screening tool developed for use in pediatric settings to identify family-level SDOH needs such as food insecurity and housing instability.

CPC Community Needs and SDOH 2

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

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