Department of Sociology, East Carolina University, Greenville, NC, USA.
Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Matern Child Health J. 2022 Jul;26(7):1529-1539. doi: 10.1007/s10995-022-03448-9. Epub 2022 May 14.
Screening for social determinants of health (SDH) has been widely adopted to identify child health risks associated with exposure to material hardship. Whereas SDH screening typically addresses a 12-month span, we sought to compare the prevalence of exposure to present (within the past year) as compared to recent (2-4 years ago) hardship among children in the United States.
We analyzed the 2014 Survey of Income and Program Participation, a nationally representative survey that interviewed participating households annually between 2014 and 2017. We included data from households with children in all waves. As of 2017, households were categorized as (1) experiencing present hardship (within the last year); (2) experiencing recent but not present hardship (any year between 2014 and 2016); and (3) experiencing no hardship over the 4-year period.
Of 2422 households, 27% experienced present hardship and 29% experienced recent but not present hardship. Households presently experiencing hardship were more likely to have Medicaid insurance, less likely to be married, and had more children than families who had experienced recent hardship. However, these groups were similar on caregivers' educational attainment, race/ethnicity, language spoken in the home, and age of the youngest child.
Our results suggest that clinical screening tools for SDH that use a 12-month time frame risk missing many children who have recently (within the past 4 years) experienced material hardship and may benefit from interventions to improve social support; a longer time frame could provide clinicians with valuable information for understanding social factors that impact child health and development.
筛查健康的社会决定因素（SDH）已被广泛用于识别与物质困难暴露相关的儿童健康风险。虽然 SDH 筛查通常涵盖 12 个月的时间跨度，但我们试图比较美国儿童目前（过去一年）和最近（2-4 年前）面临困难的比例。
我们分析了 2014 年收入和计划参与调查，这是一项全国代表性调查，在 2014 年至 2017 年期间每年对参与家庭进行采访。我们包括了所有波次中带有孩子的家庭数据。截至 2017 年，家庭被分为以下三类：（1）目前面临困难（过去一年）；（2）最近但不目前面临困难（2014 年至 2016 年的任何一年）；（3）在 4 年期间没有面临困难。
在 2422 户家庭中，27%的家庭目前面临困难，29%的家庭最近但不目前面临困难。目前面临困难的家庭更有可能拥有医疗补助保险，不太可能已婚，而且孩子比经历过最近困难的家庭多。然而，这些群体在照顾者的教育程度、种族/族裔、家庭语言以及最小孩子的年龄方面相似。
我们的结果表明，使用 12 个月时间框架的 SDH 临床筛查工具可能会错过许多最近（过去 4 年内）经历物质困难的儿童，这些儿童可能需要干预措施来改善社会支持；更长的时间框架可以为临床医生提供有价值的信息，了解影响儿童健康和发展的社会因素。
