The related press release can be found here.
Health care providers increasingly recognize that they must address economic and social factors outside the clinic if they are to improve patient health. Pediatricians bear an extra responsibility, as numerous studies have shown that adversity and stress in early childhood can interfere with healthy physical, cognitive, and emotional development well into adulthood. By screening for such health risks as food insecurity, unsafe housing, parental depression, adult employment needs, and household literacy—often referred to as social determinants of health—pediatric practices can identify vulnerable children and families and connect them through community partners to appropriate services and supports.
However, pediatricians seeking to address the social and economic concerns that can affect the health of their young patients must first build trusting relationships with parents and alleviate concerns that child protective services may be alerted.
This report, prepared by Public Agenda, is based on focus group discussions conducted over two months with low-income New York City parents, all with children age five and under. They were asked about their perceptions and reactions to pediatricians screening for social and behavioral health needs. Among the parents’ recommendations to pediatricians for effectively screening for social needs:
- Choose the right moment to ask about social needs.
- Don’t ask in front of the children.
- Signal confidentiality, where appropriate, and be transparent about what would trigger a report to child welfare.
- Do not ask just for the sake of asking.
- Make clear that screening is standard protocol.
Support for this report was provided by a grant from United Hospital Fund. UHF’s Children’s Health Initiative, which commissioned and collaborated on this work, is funded in part by the William J. & Dorothy K. O’Neill Foundation and the Ira W. DeCamp Foundation.