Screening for Poverty and Poverty-Related Social Determinants of Health.

Abstract

1. Rachel Stein Berman, MD, MPH*,† 2. Milani R. Patel, MD*,†,‡ 3. Peter F. Belamarich, MD*,† 4. Rachel S. Gross, MD, MS*,† 1. *Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 2. †Division of Academic General Pediatrics, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY 3. ‡Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY * Abbreviations: AAP: : American Academy of Pediatrics APA: : Academic Pediatric Association EITC: : Earned Income Tax Credit SNAP: : Supplemental Nutrition Assistance Program WIC: : Special Supplemental Nutrition Program for Women, Infants, and Children Pediatricians 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. 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. A 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. …