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Arnold School of Public Health

Our Current Focus

Health literacy is one SDoH within the larger list of social and environmental factors and needs which impact patient health. As exemplified during COVID-19 and the subsequent infodemic, limited health literacy complicates prevention and treatment, which can lead to poor overall health and disease management as well as increased utilization of health care services. By expanding the focus to include organizational health literacy, Healthy People 2030 is acknowledging that patient health literacy does not just fall upon the individual, but can also be improved a little further upstream, by prioritizing improvements in patient-provider communication and identification of patients in need of additional supports, such as translation services or referral to resources such as local literacy services. 

One way to improve our understanding of how SDoH, including health literacy, impact patient prevention and treatment is through the use of ICD-10 Z codes for SDoH (Z55-65), which can be applied to the patient record. National utilization of these codes has been promoted by the American Hospital Association, the South Carolina Hospital Association, and the Centers for Medicare & Medicaid Services to help standardize consideration of SDoH in patient assessment and treatment. In South Carolina, less than 1.25% of providers are utilizing SDoH Z codes in the electronic medical record 1. Thus it is critical to understand provider assessment and documentation practices regarding patient SDoH. Through focused discussions with primary care and behavioral health providers, our goal is to better understand the barriers and facilitators of SDoH documentation and referral, increase awareness and knowledge about health literacy, and ultimately provide resources and/or training to providers about SDoH and methods for improved patient-provider communication. 

1 Yang, X., Yelton, B., Chen, S., Zhang, J., Olatosi, B. A., Qiao, S., Li, X., & Friedman, D. B. (2022). Examining Social Determinants of Health During a Pandemic: Clinical Application of Z Codes Before and During COVID-19. Frontiers in public health, 10, 888459.

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