Unmet social needs in early childhood have a huge impact on health care throughout life. Economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social community context are the five domains that make up social determinants of health (SDOH) and that can shape children’s lives well into adulthood and across generations.
These conditions have long-lasting and wide-ranging consequences, including increased risk for chronic health conditions, behavioral problems and poor academic performance. Yet little research has asked parents, particularly low-income parents, for their perspectives about SDOH and how screenings can be implemented successfully. To help fill this gap, Public Agenda used the findings from our 2019 focus groups with low-income parents, summarized in the report It’s About Trust: Low Income Parents’ Perspectives on How Pediatricians Can Screen for Social Determinants of Health, to create a series of trainings for health care workers.
In partnership with United Hospital Fund’s Pediatrics for an Equitable Developmental Start Learning Network (PEDS), Public Agenda held a series of workshops with the PEDS Fellows. The fellowship is designed for early career physicians, nursing professionals, and clinical social workers in New York State who are on the frontlines of supporting families during the critical period of early childhood. The PEDS learning network aims to reduce inequities in childhood by increasing the number of primary care-based interventions that promote healthy development, address unmet social and developmental needs, and strengthen families.
The Public Agenda workshops presented key findings from the research, including parents’ recommendations about how pediatricians can ask about sensitive social needs in ways that build trust, show respect, maintain confidentiality and avoid stigmatizing or alienating parents.
The workshops also laid out best practices for community engagement. This included techniques that fellows could use to understand and connect with patients and families, an overview of digital engagement tools that medical professionals have found helpful during the pandemic, and advice on how to structure online interactions.
These tools are available to help healthcare staff to create a space where families feel comfortable sharing personal information. This is key to both individual and community health outcomes, particularly in marginalized communities, where people are more likely to come to institutions with a lower level of trust.