Measured twice: Time for the expansion of social care interventions and patient-centered outcomes

Now that the importance of social determinants of health for health, and specifically for pediatric ED outcomes, is rigorously established in the literature, the groundwork has been laid for the critical question: what next? With all this measuring, have we defined how to “cut”? It is time to move beyond examining prevalence and associations of adverse social determinants of health. This epidemiologic work has been critical in defining the problem and establishing its roots in structural racism, underinvestment in communities, and poverty. However, without the ability to effectively intervene, social risk/need assessments and continued monitoring of exposure to adverse social determinants of health become unethical.

Instead, we should develop interventions and outcome metrics, in partnership with patients and communities, to make the greatest effect within a system of constrained social resources and simultaneously build advocacy and policy momentum to increase those resources. In this editorial, we explore 2 key considerations for future interventional social care research: 1) defining the locus of intervention and 2) establishing patient-centered outcomes.