Determinants of health and pediatric primary care practices


More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association's Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty's negative impact on child health and well-being. The present article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. Attention is paid to both facilitators of and barriers to successful redesign strategies. We also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health. In addition, ways in which practices can advocate for families in their communities and nationally are identified. Finally, given the relative dearth of evidence for many poverty-focused interventions in primary care, areas that would benefit from more in-depth study are considered. Such a focus is especially relevant as practices consider how they can best help families mitigate the impact of poverty-related risks in ways that promote long-term health and well-being for children.

Beck AF, Tschudy MM, Coker TR, et al. Determinants of health and pediatric primary care practices. Pediatrics. 2016;137(3):e20153673. PMID: 26933205. DOI: 10.1542/peds.2015-3673.

Publication Year: 
Resource Type: 
Peer Reviewed Research
Study Design: 
Social Determinant of Health: 
Economic Security
Housing Quality
Legal Services
Not Specified
Public Benefits
Children and Youth
Social Needs/ SDH
Health & Health Behaviors
Patient Experience of Care
Provider Experience of Care
Screening Research: