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Incorporation of Social Risk in US Preventive Services Task Force Recommendations and Identification of Key Challenges for Primary Care

Educational Objective
To understand how health equity and social risks can be incorporated into the methods and recommendations of the US Preventive Services Task Force (USPSTF).
1 Credit CME
Abstract

Importance  In its mission to improve health, the US Preventive Services Task Force (USPSTF) recognizes the strong relationship between a person’s health and social and economic circumstances as well as persistent inequities in health care delivery.

Objective  To assess how social risks have been considered in USPSTF recommendation statements and identify current gaps in evidence needed to expand the systematic inclusion of social risks in future recommendations.

Evidence  The USPSTF commissioned a technical brief that reviewed existing literature on screening and interventions for social risk factors and also audited the 85 USPSTF recommendation statements active as of December 2019 to determine how social risks were addressed in clinical preventive services recommendations.

Findings  Among the 85 USPSTF recommendation statements reviewed, 14 were focused on preventive services that considered health-related social risks. Social risks were commonly referenced in parts of USPSTF recommendations, with 57 of 85 recommendations including some comment on social risks within the recommendation statement, although many comments were not separate prevention services. Social risks were commented on in USPSTF recommendations as part of risk assessment, as a marker of worse health outcomes from the condition of focus, as a consideration for clinicians when implementing the preventive service, and as a research need or gap on the topic.

Conclusions and Relevance  This report identified how social risks have been considered in the USPSTF recommendation statements. It serves as a benchmark and foundation for ongoing work to advance the goal of ensuring that health equity and social risks are incorporated in USPSTF methods and recommendations.

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Article Information

Corresponding Author: Karina W. Davidson, PhD, MASc, Feinstein Institutes for Medical Research at Northwell Health, 130 E 59th St, Ste 14C, New York, NY 10022 (chair@uspstf.net).

Accepted for Publication: July 16, 2021.

Published Online: September 1, 2021. doi:10.1001/jama.2021.12833

Author Contributions: Dr Davidson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of Interest Disclosures: None reported.

Disclaimer: The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of the Agency for Healthcare Research and Quality (AHRQ). No statement in this report should be construed as an official position of AHRQ or the US Department of Health and Human Services.

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