Sustainably implementing social determinants of health interventions in the pediatric emergency department

Social determinants of health (SDOH) represent a glocal problem, with both global and local factors at play. They stem from universally rooted causes such as structural racism, eg, policies, laws, and regulations that systematically result in differential access to services and opportunities in society based on race. They are also contextual, based on unique patient population characteristics, community features, and social, economic, and political structures that together confer social risk. Unmet pediatric health-related social needs (HRSN), domains in which an individual desires assistance, are correlated with poverty, are relatively common among households with children, disproportionately affect people of color, and increase reliance on emergency and hospital care. Awareness and programmatic structure around HRSN have steadily increased among general pediatric office settings as well as national medical associations and regulatory bodies.