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临床方法减轻贫困导致的物质困难:社会风险/需求识别和干预。

Clinical Approaches to Reducing Material Hardship Due to Poverty: Social Risks/Needs Identification and Interventions.

机构信息

Department of Pediatrics, University of Massachusetts Medical School (A Garg), Worcester, Mass.

Department of Pediatrics, Boston Medical Center (A Brochier and E Messmer), Boston, Mass.

出版信息

Acad Pediatr. 2021 Nov-Dec;21(8S):S154-S160. doi: 10.1016/j.acap.2021.02.007.

Abstract

The field of pediatrics has pioneered approaches to mitigating poverty's harmful effects on children's health and development. Clinical interventions for systematically addressing material hardships due to poverty within the context of pediatric care delivery, however, are still in their infancy. Since the American Academy of Pediatrics published its policy statement on Child Health and Poverty in the United States in 2016, interest has surged in the development and implementation of care models that systematically identify and address social risks and/or social needs. This article explores this major shift in interest, research, and investment in such interventions within pediatric care. We provide an overview of current screening and referral models for addressing poverty-related social factors and explore the strengths and weaknesses of these varied approaches. We summarize the current evidence supporting such clinical approaches, and comment on the importance of multi-sectoral partnerships in addressing families' and communities' needs. Lastly, we propose future directions for research and pediatric practice that may enhance the uptake of social risks/needs interventions and bolster the evidence of their effectiveness. Though clinical approaches for addressing material hardship may be limited by an insufficient social safety net and other barriers, interventions to identify and address families' social risks and social needs have the potential to combat poverty's impact on children and advance health equity.

摘要

儿科领域开创了减轻贫困对儿童健康和发育的有害影响的方法。然而,在儿科护理提供的背景下,针对贫困导致的物质困难进行系统干预的临床方法仍处于起步阶段。自美国儿科学会 2016 年发布其关于美国儿童健康与贫困的政策声明以来,人们对开发和实施系统识别和解决社会风险和/或社会需求的护理模式的兴趣大增。本文探讨了儿科护理中此类干预措施在兴趣、研究和投资方面的重大转变。我们概述了当前针对与贫困相关的社会因素的筛查和转介模式,并探讨了这些不同方法的优缺点。我们总结了支持这些临床方法的现有证据,并评论了多部门合作在满足家庭和社区需求方面的重要性。最后,我们提出了未来可能增强社会风险/需求干预措施的采用和增强其有效性证据的研究和儿科实践方向。虽然解决物质困难的临床方法可能受到社会安全网不足和其他障碍的限制,但识别和解决家庭社会风险和社会需求的干预措施有可能对抗贫困对儿童的影响,促进健康公平。

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