Social determinants of health screening and remote intervention for a pediatric emergency department: Reaching rural families

BACKGROUND AND OBJECTIVES: Social determinants of health (SDOH) can have profound impacts on children, though many lack access to SDOH programs. Our objective was to determine feasibility and outcomes of a SDOH program for families of children seen in an emergency department (ED) serving an under-resourced rural population. 

METHODS: This prospective cohort study assessed for 11 domains of SDOH among families of pediatric ED patients. Families with positive screens were contacted following their ED visit and provided resources. Fisher exact and Chi-square tests were used to identify sociodemographic factors associated with SDOH and resource requests. 

RESULTS: Of the 95 surveys administered, 42% were positive for ≥1 SDOH, most frequently food scarcity (27%). Forty percent of families with positive SDOH needs screens requested services, of which remote resource assistance was performed successfully with 75%. Families with an unemployed primary caregiver (P = .04) and Medicaid insurance (P < .001) were more likely to screen positive for SDOH needs. Forty percent of respondents were from surrounding rural counties and were less likely to request resources (P = .01). 

CONCLUSIONS: SDOH needs are common among families utilizing EDs for their children's health care. EDs serving under-resourced rural communities can be leveraged to address SDOH needs, and further research is needed to evaluate their impacts on rural families.