Screening for social determinants of health in pediatric primary care

Social determinants of health have been well established. On a population or community level, exposures such as income inequality, neighborhood violence, or the relative unavailability of healthy food have been associated with poor health. On an individual level, adverse social circumstances constitute known risk factors for both a greater prevalence and an increased severity of many chronic health conditions. Such is the case, for example, with poor housing conditions and childhood asthma. In addition to specific conditions or diseases, adverse social circumstances impact children's social and intellectual development, school functioning, and general well being. In the specific case of child intellectual achievement, as social risk factors compound, outcomes worsen dramatically. Screening for-and addressing-social issues as part of pediatric health care, therefore, is potentially important.