The Impact of Social Determinants of Health on the Identification and Outcomes of Depression in Primary Care

Abstract

Social determinants of health (SDOH) may significantly impact treatment outcomes for depression in primary care. An analysis of patients in collaborative care was conducted to explore the association between SDOH and depression baseline scores and treatment outcomes as assessed by the Patient Health Questionnaire-9 (PHQ9). Although individuals’ baseline PHQ9 scores did not differ by SDOH flag, there was a direct effect of SDOH on PHQ9 reduction rates. SDOH did not significantly moderate the association between collaborative care treatment and depression outcomes. Individuals flagged with SDOH showed higher depression scores at the end of the treatment despite a higher clinical dosage. Routine screening for SDOH in collaborative care and primary care should be further explored.