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Abstract
Social determinants of health (SDH) are the external conditions in which a child and his or her family live, work, learn, and play that can impact quality of health. The impact of SDH is often negative when a child is living in poverty. We utilized the HealthBegins Upstream Risks Screening Tool to evaluate children and families attending a low-income clinic in Southern Ohio/Northern Kentucky. Results were used to connect the children and their families to local community resources to address the SDH areas of greatest need. Population data on these children and their families informed the screening process and reinforced the need for this non-clinical, social service. Undergraduate and graduate students were effective in obtaining information to address SDH in the primary care setting.
Keywords: Social determinants of health, federallyqualified health center, students, asthma, public health
Introduction
Margaret Whitehead, DBE was one of the first to establish inequity in health as unfair and unjust (1). In cities across the United States health inequity can result in a life expectancy gap between the rich and the poor of up to fifteen years (2). Limited access to medical care and unhealthy behaviors have traditionally been accepted as causes for poor health outcomes (3). However, limited access to medical care and unhealthy behaviors only account for a portion of poor health outcomes (4). A broader explanation for health disparities may be attributed to a person's social environment, or "the circumstances in which people are born, grow up, live, work, and age" as the social determinants of health (SDH) (5). Children living in poverty with its associated SDH, are at greater risk for adverse health outcomes such as asthma and are less likely to receive consistent preventive care (e.g., Well-Child Checks) than children from families with high incomes (6-8).
Pediatric primary care providers have long provided primary prevention, and the screening necessary for secondary prevention (9) with a variety of guidelines and screening tools to address SDH in the primary care setting (10, 11). It is currently recommended that SDH screening tools be used for families of pediatric patients during well-child checks and paired with education on available community resources (12, 13). Despite the growing evidence of the important role of SDH in child health, addressing SDH...