Screening for Social Determinants of Health in Pediatric Primary Care
Abstract
<P>Social determinants of health have been well established. On a population or community level, exposures such as income inequality, neighborhood violence, or the relative unavailability of healthy food have been associated with poor health. On an individual level, adverse social circumstances constitute known risk factors for both a greater prevalence and an increased severity of many chronic health conditions. Such is the case, for example, with poor housing conditions and childhood asthma. In addition to specific conditions or diseases, adverse social circumstances impact children’s social and intellectual development, school functioning, and general well being. In the specific case of child intellectual achievement, as social risk factors compound, outcomes worsen dramatically. Screening for — and addressing — social issues as part of pediatric health care, therefore, is potentially important.</P> <H4>ABOUT THE AUTHORS</H4> <P>Michael Silverstein, MD, MPH; Kathleen Conroy, MD; and Megan Sandel, MD, MPH, are with the Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA.</P> <P>Address correspondence to: Michael Silverstein, MD, MPH, Boston Medical Center, Vose Hall 3, 88 East Newton Street, Boston, MA 02118; fax: 617-414-6191; e-mail: <a href="mailto:[email protected]">[email protected]</a>.</P> <P>Dr. Silverstein, Dr. Conroy, and Dr. Sandel have disclosed no relevant financial relationships.</P> <H4>EDUCATIONAL OBJECTIVES</H4> <OL> <LI>Review the evidence for clinic-based screening for the social determinants of pediatric health conditions.</LI> <LI>Discuss the evidence for screening for maternal depression and domestic violence.</LI> <LI>Determine the evidence for screening for food insecurity, housing, and practices affecting early education and school readiness.</LI> </OL>
