Addressing patients' social health risks at hospital: lessons from "social prescribing" activities

Abstract

Patients' socioeconomic and psychosocial statuses, such as poverty and isolation, can affect their health and treatment adherence. However, few standard procedures for addressing these social risks in clinical settings are available. "Social prescribing" posits that linking patients with social risks to necessary community social resources. In this study, we review the currently available global evidence on social prescribing activities and their effectiveness, and discuss the opportunities and challenges in the implementation of similar schemes in Japanese health care systems. Our review revealed that social prescribing had become popular in the United Kingdom. The Social Prescribing Network in the UK defines social prescribing as "enabling healthcare profes­sionals to refer patients to a link worker, to co-design a non-clinical social prescription to improve their health and wellbeing." Empirical evidence suggests that social prescribing might be effective in improving patients' mental health status and reducing medical expenditure and unnecessary emergency department visits. Similar activities have also been reported in Japan. Potential challenges in implementing "social prescribing" schemes in Japan include establishing standardized screening tools for patients' social risks, incentivizing systems for clinical practitioners for their social prescribing activities, and cultivating human resources that work as "link workers" who connect patients from healthcare facilities to formal and informal services/organizations in the community, as well as strengthening community governance in patient-centered integrated care systems. Further research is needed to evaluate the effectiveness of social prescribing activities as well as efforts to raise awareness and knowledge among clinical practitioners on the importance of evaluating and addressing the social determinants of health in clinical settings.