Social interventions and health care utilization for child asthma—what’s in a name?

Social determinants of health are the causes of discrepancies in pediatric health outcomes. Upstream determinants, or causes, typically include complex societal issues, such as racism and poverty. Midstream determinants are typically the result of upstream determinants but are potentially more modifiable social risks for poor health outcomes (eg, housing instability, food insecurity, educational attainment, incarceration, and exposure to violence). Addressing midstream social risks to improve outcomes—for example, improving social cohesion (eg, building social support networks) among community members—has been associated with improved physical health and psychological well-being.