Screening for poverty and poverty-related social determinants of health

Given the known negative outcomes associated with poverty, it is important for pediatricians to identify families living in poverty. This need has been long recognized by the American Academy of Pediatrics (AAP) and the Academic Pediatric Association (APA), and in the spring of 2016, these organizations independently issued statements addressing the growing problem of childhood poverty and its implications for children’s health. The statements urge pediatricians to screen for poverty-related social determinants of health, to develop interventions to reduce the adverse effects of poverty, and to advocate for programs and policies aimed at eliminating childhood poverty. The AAP and APA recommend several programs that pediatricians may establish in their practices and encourage pediatricians to advocate for specific governmental policies addressing poverty. The statements highlight that pediatric providers are uniquely positioned to address childhood poverty through their common objective of preventing childhood diseases, through their opportunity to provide anticipatory guidance throughout children’s lives, and through their shared passion for supporting children and families.

The objectives of this article are 1) to review screening tools for poverty and poverty-related social determinants of health that pediatricians may use in practice; 2) to describe interventions that support patients whose screens are positive; and 3) to outline government policies and programs for families living in poverty for which pediatricians may advocate. As an example, we describe how we address each of these items in our urban academic general pediatric practice, located in one of the poorest communities in the United States.