Health-related social needs, such as the need for housing stability, food security or reliable transportation, are observed in many emergency department (ED) patients, a new study shows. However, the resolution of HRSN is still up for debate as to whether or not it improves ED use. The answer may be more complicated than researchers think. These data were reported by Abbey C. Sidebottom, MPH, PhD, from Allina Health, Minneapolis, and colleagues, in a manuscript published Monday online in the Journal of the American Medical Association. Investigators in this retrospective cohort study examined the relationship between HSRNs and ED use, as well as inpatient numbers. The HSRNs assessed in the analysis were housing stability, housing quality, food security, transportation, utilities and interpersonal safety. Researchers measured patients’ individual HSRNs, the number of HSRNs and if these needs were solved by the end of the follow-up period. A total of 166,682 (60.3% women, 43.4% over or at 65 years old) Medicare and Medicaid patients from a single health system were screened for HSRNs between June 2018 and January 2022. The Accountable Health Communities (AHC) program was used to gather patient data. Analyses were performed between June 2024 and September 2025. Included measures were inpatient admissions and ED visits within 6 months before baseline screening, as well as 6 months after patient follow-up. Resolution of HSRNs 6 months after follow-up was also analyzed. Adjustments were made for individual HSRNs, demographics and health conditions. After adjusting for covariates, all six HSRNs were associated with ED visits to an extent. Housing quality was the only variable that had lower odds of ED use, while all the others had higher odds of ED use. Housing stability (odds ratio [OR]=1.25; 95% confidence interval [CI]=1.18-1.33) and transportation (OR=1.31; 95% CI=1.25-1.38) had the greatest associations with higher rates of ED use: 26.9% of patients who needed housing stability and 25.6% of patients who needed transportation made visits to the ED during the study time frame. When adjustments were made for HSRNs, demographics and comorbidities, only housing stability and transportation continued to have an association with ED visits. During the follow-up screening, resolution of HSRNs did not significant change ED use after adjustments were made for other HSRNs, demographic characteristics and comorbidities. Overall, the investigators in this study concluded that more research is needed to determine how HSRNs influence ED use since resolution of HSRNs did not improve ED use rates in this study. Omolola E. Adepoju, PhD, MPH, from the University of Houston College of Medicine, Texas, discussed the evaluation of social needs in the health care setting in an accompanying editorial, noting that research has pointed to the same conclusions: meeting social needs has yet to significantly alter avoidable health care use. But perhaps investigators aren’t looking at the data correctly? “Despite increasing enthusiasm and investment in social needs interventions, their impact on health care utilization remains elusive,” Dr. Adepoju wrote. “Is this truly the case, or do these findings instead reflect a limitation in how researchers define resolution and measure it in this line of research?” Dr. Adepoju also noted the instability of social conditions and the difficulty in measuring them. Temporary fixes of HSRNs do not account for the revolving door of stability in many social needs. “Utilization measures, such as emergency department visits, inpatient hospitalizations, and readmissions, become the default outcome because they are important, measurable, and fit within the existing reimbursement and reporting systems. Nevertheless, these metrics capture only the downstream consequences,” the editorialist wrote. Dr. Adepoju concluded by highlighting the importance of health care reform and quoting another manuscript by Michael Marmot, FRCP, of the University College London Department of Epidemiology and Public Health, “Why treat people and send them back to the conditions that made them sick?” Sources: Sidebottom AC, Martins S, Vacquier MC, et al. Health-related social needs and health care utilization in the accountable health communities model. JAMA Netw Open. 2025 Dec 15 (Article in Press). Adepoju OE. Rethinking social needs and health care utilization – treating the symptom, not the cause. JAMA Netw Open. 2025 December 15 (Article in Press). M Marmot. The health gap: The challenge of an unequal world. Lancet. 2015 Dec 12. doi: 10.1016/S0140-6736(15)00150-6. Image Credit: Fauzi – stock.adobe.com