Ettinger de Cuba Stephanie, Ruemmele Carley, Poblacion Ana
Boston University School of Public Health.
Boston University Chobanian and Avedisian School of Medicine.
Curr Opin Pediatr. 2025 Feb 1;37(1):19-26. doi: 10.1097/MOP.0000000000001416. Epub 2024 Nov 12.
To contextualize how pediatrics led the field in developing and implementing tools to screen for social determinants of health in clinical care as well as in creating innovative interventions to mitigate them, and to summarize where the evidence points as the next frontier.
The evidence showed that health-related social needs (HRSN), like food insecurity, energy insecurity, and housing instability, continue to drive poor health outcomes across the lifespan; patients and healthcare providers are open to discussing HRSN in clinical settings, though some providers feel ill-equipped to do so; to mitigate HRSN, healthcare plays a unique role in ensuring patients' HRSN are understood, referring to effective resources through building strong, lasting relationships with community partners, embedding services in the healthcare setting across all departments, and empowering patient families to participate in programs and services; and administrative burden hinders families from getting all the benefits to which they are entitled, which streamlined co-enrollment processes can address.
Pediatric providers can add a unique and credible voice to seeking changes to the safety-net, including co-enrollment, that could reduce administrative burden, address patients' HRSN, and improve health starting in the prenatal period through later adulthood.
阐述儿科学如何在临床护理中引领开发和实施健康社会决定因素筛查工具,并创建创新干预措施以减轻这些因素的影响,同时总结证据所指向的下一个前沿领域。
证据表明,与健康相关的社会需求(如粮食不安全、能源不安全和住房不稳定)在整个生命周期中持续导致不良健康结果;患者和医疗服务提供者愿意在临床环境中讨论与健康相关的社会需求,尽管一些提供者觉得自己没有能力这样做;为减轻与健康相关的社会需求,医疗保健在确保患者的与健康相关的社会需求得到理解方面发挥着独特作用,通过与社区伙伴建立牢固、持久的关系来推荐有效的资源,在所有部门的医疗保健环境中嵌入服务,并使患者家庭有能力参与项目和服务;行政负担阻碍家庭获得他们应得的所有福利,简化的联合注册流程可以解决这一问题。
儿科医疗服务提供者可以在寻求对安全网进行变革(包括联合注册)方面发出独特且可信的声音,这可以减轻行政负担,解决患者的与健康相关的社会需求,并从产前时期到成年后期改善健康状况。