Addressing social determinants of mental health in pediatrics during the COVID-19 pandemic

In our article published in June 2019, “The Relationship Between Social Risks and the Mental Health of School-Age Children in Primary Care,” we examined the association between social risks and mental health among children screened in primary care pediatrics at an urban safety-net hospital. More social risks on the WE CARE screener (including caregiver education, childcare employment, food security, heat, and housing) were associated with worse overall child mental health measured with the Pediatric Symptom Checklist (PSC-17). Individually, food insecurity and unemployment were associated with worse child mental health after adjusting for sociodemographic characteristics and other social risks.

Since our paper's publication, the COVID-19 pandemic worsened social risks and health disparities, increasing calls to improve health equity and address adverse social determinants of health (SDOH) as part of healthcare practice. The pandemic also accelerated an already troubling downward trend in child mental health, paired with a deepening access crisis to pediatric psychiatric services, aggravated by adverse SDOH and racism.