Screening for Poverty and Poverty-Related Social Determinants of Health

Practice GapPediatricians should screen for and address poverty and poverty-related social determinants of health because they have clear negative effects on children's health and well-being.This task requires coordination of services beyond the medical home.Pediatricians may also advocate at local and federal levels to further serve patients living in poverty.Objectives After completing this article, readers should be able to:1. Define social determinants of health and understand their effect on children's health.2. Access tools to screen for poverty and poverty-related social determinants of health.3. Describe evidence-based interventions that address poverty and poverty-related social determinants of health.4. Outline government policies and programs for impoverished families for which pediatricians may advocate. CASE SCENARIOA 13-year-old girl has an appointment with her pediatrician for follow-up of her asthma.She had gone to the emergency department 3 times in the 10 days before the appointment for cough and difficulty breathing.Each time, she was given nebulizer treatments, improved, and was discharged home.She was also treated with oral corticosteroids and azithromycin.Her symptoms have persisted up to the day of the appointment.Her mother reports complete compliance with her inhaled medications, oral corticosteroids, and antibiotic.On further questioning, her mother reports that she, the patient, and the patient's younger brother are living in a shelter.The shelter apartment they initially lived in had no heat, so they were transferred to an apartment on a different floor.The heat did not work in the new apartment, so they were transferred to an apartment in another building, which did not have heat or hot water.The patient's mother tried using the stove to heat the apartment, but it had a strangeVol. 39 No.