Youths' health-related social problems: concerns often overlooked during the medical visit

J Adolesc Health. 2013 Aug;53(2):265-71. doi: 10.1016/j.jadohealth.2013.02.024. Epub 2013 May 1.


Objective: The objectives of this study were to (1) measure the prevalence of health-related social problems among adolescent and young adult primary care patients; (2) estimate previous screening and referral experiences; and (3) examine participant attitudes toward screening and referral.

Methods: Data were collected as part of a cross-sectional study conducted in an urban young adult clinic. Patients aged 15 to 25 years completed a computerized questionnaire screening for health-related social problems in nine social domains. In addition, participants answered questions about their previous screening experiences, need for referrals, and their experience using the system.

Results: Seventy-six percent (304/401) of youth screened positive for at least one major problem, including healthcare access (37%), housing (34%), and food security (29%). Forty-seven percent (190/401) experienced major problems in two or more social domains. The prevalence of screening in the past year for each domain averaged 26%; 3% were screened in all nine domains in the previous 12 months and 33% were not screened in any domain. Overall, 75% needed a referral within the previous year, and 42% identified at least one unmet referral need. The majority (84%) of participants reported that it was acceptable to screen for these problems.

Conclusion: Prevalence of health-related social problems among youth is high. The majority needed at least one referral for a social need in the previous year. Primary care physicians would benefit from improved systems for screening and referral of health-related social problems in order to create a comprehensive medical home for their patients.

Keywords: Adolescents; Patient-centered care; Screening; Social problems; Technology; Young adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Health Services*
  • Cross-Sectional Studies
  • Educational Status
  • Feeding and Eating Disorders / epidemiology
  • Female
  • Food Supply / statistics & numerical data
  • Health Services Accessibility / statistics & numerical data
  • Housing / statistics & numerical data
  • Humans
  • Income / statistics & numerical data
  • Infant Equipment / statistics & numerical data
  • Male
  • Office Visits*
  • Referral and Consultation
  • Social Problems*
  • Substance-Related Disorders / epidemiology
  • Surveys and Questionnaires
  • Violence / statistics & numerical data
  • Young Adult