A multidimensional framework for mapping social need to electronic health records in people with multimorbidity

Social needs are sociocultural and economic factors influencing health and quality of life, including, for example, mobility limitations or financial difficulties. Multimorbidity - the presence of two or more long-term conditions (LTCs)- is an increasing public health challenge, with social needs often compounding the negative health outcomes associated with multimorbidity. In this study, we present a novel multidimensional framework for identifying and characterising social needs within a population-based cohort of adults with multimorbidity in England, utilising data from the Clinical Practice Research Datalink. The framework identifies eight critical domains of social needs: activities of daily living, mobility, financial constraints, disability, community care, housing status, social support, and bereavement. More than 100 related variables were captured in the dataset. Among 7,290,716 individuals with multimorbidity, 36.96% reported at least one social need, with the majority of affected individuals being older, female, and experiencing a higher burden of LTCs. The most prevalent social needs were related to community and social care services. Our findings underscore the significant association between social needs and multimorbidity, revealing a disproportionate burden of social needs in this population. This framework offers a systematic approach to quantifying and measuring social needs, providing a foundation for incorporating these factors into clinical care and interventions.