How Can Clinical Communication Alleviate the Negative Impacts of Social Determinants of Health?: A Secondary HINTS 6 Dataset Analysis.

Abstract

Structural disparities (eg, food insecurities, housing, and lack of transportation) at different social levels (eg, personal, family, and community) are strong determinants of health, influencing individuals' and population well-being worldwide. Research is scarce examining how clinical communication can mitigate the negative impact of social disparities obstructing the reception of quality healthcare. In this study, we explore the mediation role of patient-centered communication (PCC) between social determinants of health (SDH) and quality of care. Using a sample of 5437 adult who visited a healthcare provider in the past 12 months from the sixth Health Information National Trends Survey (HINTS 6), our key points of findings included that the models showed PCC partially mediating the connections from (a) "skipped meals" (effect = -.08, 95%CI = [-.12, -.04]), (b) "unaffordable meals" (effect = -.08, 95%CI = [-.11, -.05]), (c) "fear of eviction" (effect = -.1, 95%CI = [-.14, -.06]), and (d) "lack of transportation" (effect = -.12, 95%CI = [-.16, -.08]) to quality of care (QoC). Specifically, better communication had a positive impact on mediating the disparities; poor communication did not. Demonstrating in a nationally representative sample, our findings indicate the key role of patient-centered clinical communication in effectively alleviating the inherent challenges faced by people with low health literacy and socioeconomic status. Theoretical and practical implications are discussed.