Purpose: Social determinants of health (SDoH) including insecure access to food, housing, and financial resources are critical threats to overall health. We sought to examine this relationship among adult primary care patients with multiple chronic conditions. Methods: We obtained cross-sectional data on 2763 adults with chronic medical and behavioral conditions or greater than 2 chronic medical conditions from a survey of participants in Integrating Behavioral Health and Primary Care, a multicenter randomized trial. Results: The prevalence of 1 or more insecurities was reported in 29% of participants, including food (13%), housing (3%), or financial (25%). Functional capacity ranged from 2.74 to 9.89 metabolic equivalents (METs) (median, 6.05). The distribution of functional capacity was significantly lower for those with any 1 or more SDoH than for those without. Each insecurity independently affected the functional capacity in multivariable analysis. Conclusions: Among primary care patients with chronic conditions, SDoH are associated with poorer functional capacity, independent of other social and demographic factors. Primary care offers a promising, if underused, opportunity to intervene in SDoH. There is a need for future studies to explore the role of screening and intervention by primary care providers to mitigate or prevent SDoH.

中文翻译：

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成人初级保健多重慢性病患者健康的社会决定因素与功能能力的关系

目的：健康的社会决定因素 (SDoH)，包括对食物、住房和财政资源的不安全获取，是对整体健康的严重威胁。我们试图检查患有多种慢性病的成人初级保健患者之间的这种关系。方法：我们从一项多中心随机试验整合行为健康和初级保健的参与者调查中获得了 2763 名患有慢性疾病和行为疾病或 2 种以上慢性疾病的成年人的横断面数据。结果： 29% 的参与者报告了一种或多种不安全感，包括食物 (13%)、住房 (3%) 或财务 (25%)。功能容量范围为 2.74 至 9.89 代谢当量 (MET)（中值，6.05）。具有任何 1 个或多个 SDoH 的人的功能能力分布显着低于那些没有的人。在多变量分析中，每个不安全感独立地影响功能能力。结论：在初级保健慢性病患者中，SDoH 与较差的功能能力相关，独立于其他社会和人口因素。如果未充分利用，初级保健提供了一个有希望的机会来干预 SDoH。未来的研究需要探索初级保健提供者的筛查和干预在减轻或预防 SDoH 方面的作用。独立于其他社会和人口因素。如果未充分利用，初级保健提供了一个有希望的机会来干预 SDoH。未来的研究需要探索初级保健提供者的筛查和干预在减轻或预防 SDoH 方面的作用。独立于其他社会和人口因素。如果未充分利用，初级保健提供了一个有希望的机会来干预 SDoH。未来的研究需要探索初级保健提供者的筛查和干预在减轻或预防 SDoH 方面的作用。