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Bringing the Social Determinants of Health into Obstetric Care

In This Video

  • Social determinants of health, or the context of your life, like the community you live in, impact your health and wellness
  • The OB/GYN Department at Massachusetts General Hospital started universal screening for the social determinants of health
  • When a pregnant person comes in for their first obstetric appointment, they complete a questionnaire asking them about things like housing, transportation and utilities so they can be referred to resources if necessary

In this video, Katherine Rushfirth, CNM, MSN, associate chief of the Midwifery Service in the Department of Obstetrics and Gynecology at Massachusetts General Hospital, discusses the department's approach to community health, incorporating social determinants of health into the care of their patients.


When you talk about community health you are thinking about health and wellness in a much broader social context. So in our community health work we're thinking about kind of what programs, what policies, what advocacy do we need to do so that all our patients and family have equal access to health care and equal opportunity to health and wellness.

Community health is really essential to any hospital and any health care center, and partly because there is more and more evidence coming out that the context of your life is actually the thing that is going to impact your health. So we always think about health and people think about their family history or they think about individual health behaviors, like do you smoke, do you exercise? But what we're finding is that the context in which you live, the community in which you live, these are the things that are going to more so impact your health and wellness, and we call these the social determinants of health. So part of our job here at Mass General is to assess for the social determinants of health.

So I think that when patients come to their midwife or doctor appointment, most people are not used to being asked questions about, "What's your housing situation? Do you have food in the house?" But those are actually really important questions, and I've been really, really excited in our OB/GYN Department, last year we started universal screening for the social determinants of health. When women come for their first obstetric appointment, they're all handed a one-page sheet, it's got about eight questions on it, asking them about things like housing, transportation, can they pay for their utilities this month. And with that, we've created a lot of resources and a lot of referrals, so that if we get a positive screen, if someone says, "Actually, yeah, I'm having a hard time with my heat bill", we know where to go to really support that person or support that family.

My hope and goal is that we become a real center of excellence for this and that people know they can come to us with these issues and we are going to respond to get them the services or get them the extra support they need to have healthy pregnancies and to really sort of live full and healthy lives that they would like to be living.

Learn more about the Midwifery Service

Refer a patient to the Department of Obstetrics and Gynecology


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