Unmet social needs in early childhood can have long-lasting and wide-ranging consequences, including increased risk for chronic health conditions, behavioral problems and poor academic performance. The American Academy of Pediatrics in 2016 called on its members to begin universally screening for social needs and facilitating connections to community resources as a part of routine care.

Yet little research has asked parents, particularly low-income parents, for their perspectives about social determinants of health and how screenings can be implemented successfully. To help fill this gap, Public Agenda, with support from United Hospital Fund, conducted focus group research with low-income parents in New York City to understand parents’ perspectives on social needs screenings.

Findings include:

  • Parents in these focus groups cited a broad range of social stressors that affected their children’s health and well-being, including some that screening tools for social determinants of health may not currently include.
  • These parents did not immediately identify pediatricians as sources of help with social stressors. Their reactions to the idea of pediatricians discussing these stressors were mixed. They saw some topics, such as nutrition, education and minor behavioral issues, as appropriate to discuss with pediatricians, but others, such as domestic violence, parents’ mental health and legal issues, as more sensitive.
  • Parents’ concerns about discussing sensitive social needs with pediatricians included worries about being judged and discriminated against, fear of intervention by a child welfare agency, lack of time during appointments and frustration at the prospect of disclosing sensitive information without getting help.
  • Parents’ recommendations for pediatricians about discussing social determinants of health included building trust, choosing the right moment and making clear that screening is standard protocol.