Monday, January 5, 2015

The Importance of Being Earnest in Making Sure You Ask About Social Determinants of Health

By: Lewis First, MD, MS; Editor-in-Chief 
Courtesy of Donnie Ray Jones@Flickr


     The more we take into account a family’s unmet social needs, the better the outcome for the child—or so we understand based on a myriad of articles published over the past few years in our journal and others. Yet if we not only screen but refer families to community resources to meet those unmet needs, does it improve the health and wellbeing of those families?  
     Gang et al. (doi: 10.1542/peds.2014-2888) elected to address this question through a cluster randomized controlled trial involving eight urban community health centers where four centers asked mothers to complete a self-report of unmet family needs and then made referrals to assist in those needs—and four provided routine care.       
     The results are dramatic and well worth your attention in what happened to those families receiving the intervention. Do you ask about social determinants of health in your patients or better yet—make referrals to community agencies and resources once those determinants have been identified?   
     To help further stress the import of what this study suggests, Dr. Robert (Bob) Block, former AAP President and now newly named director of the AAP’s  Center on Child Health and Resilience provides an accompanying commentary (10.1542/peds.2014-3656) that further highlights the need to screen for social needs of families, make referrals and in turn increase the opportunities for strengthening resiliency in these families and most importantly their children. Read both the article and the commentary and if you are not screening for social determinants of health in your patients, you will hopefully do so as a result of what you learn.

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