Primary Care Physicians Link Social Barriers to Poor Health

One common example of a stubborn environmental barrier that is cited by physicians is childhood asthma triggered by mold in substandard housing.

"If you are a physician, particularly a pediatrician, and you know the asthma could be easily managed if the environmental factors were changed, that has to be enormously frustrating," she said.

Lowe says the long-term costs of frequent asthma attacks have to be measured along with the short-term costs of frequent trips to a pediatrician or the emergency department.

"Asthma one of the biggest single causes of school absenteeism and it causes children to fall further and further behind in their studies," she said. "It has tremendous implications for their growth and development not just physically but socially, emotionally, and educationally."

Lowe says primary care physicians simply don't have the time to chase down and correct the socio-economic conditions that lead to adverse health effects for their patients. With that in mind, Lowe says she hopes the survey will bolster support for a RWJF-funded program called Health Leads that is now underway in about a half-dozen cities across the nation.

Health Leads relies on trained volunteer college students working with healthcare providers to identify social issues such as substandard housing or poor nutrition that may adversely impact patients' health. In addition, some hospitals team up with legal aid attorneys and other interdisciplinary teams that include social workers who take on substandard housing issues and other barriers.

"We are not naïve to think that physicians are going to do this," she says. "The most hopeful thing about this survey is that physicians are recognizing that there are these unmet social needs that are important to address, even though they don't know what to do about it."