When should patients be screened for SDOH?

• A. Only after admission.
• B. Only during initial intake.
• C. Every patient, every encounter (not selectively).
• D. Only when they request services.

Answer: (C)

Universal screening of social determinants of health should happen for every patient at every encounter. This approach makes assessing social needs a routine part of care, so information is consistently collected, kept up to date, and available to inform treatment and referrals.

Why this is best: patients’ social circumstances can change over time and across episodes of care. By screening at every encounter, clinicians can detect new or evolving barriers—like housing instability, food insecurity, transportation issues, or lack of social support—and connect patients with appropriate resources sooner, which can improve health outcomes and adherence. It also avoids bias that can come from only screening a subset of patients or waiting for patients to request help.

Why the other timings aren’t as effective: screening only after admission or only at the initial intake misses changes that occur during care and may overlook needs that emerge later. Screening only when patients request services relies on patients recognizing and voicing need, which many may not do due to stigma, lack of awareness, or uncertainty about what help is available.