Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians
Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians
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DOI：
10.1016/j.cppeds.2016.02.004
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发表时间：
2016-05-01
影响因子：
1.6
通讯作者：
Fierman, Arthur H.
中科院分区：
文献类型：
--
作者：
Chung, Esther K.;Siegel, Benjamin S.;Fierman, Arthur H.
在美国，大约20%的儿童生活在贫困中，这种情况存在于农村、城市和郊区。因此，所有儿童健康临床医生都需要熟悉贫困对健康的影响，并了解影响健康的相关、可预防和可改变的社会因素。健康的社会决定因素是医疗问题的可识别根源。对于生活在贫困中的儿童，临床医生可能发挥作用的健康社会决定因素包括：虐待儿童，儿童保育和教育，家庭经济支持，物理环境，家庭社会支持，亲密伴侣暴力，孕产妇抑郁症和家庭精神疾病，家庭药物滥用，枪支暴露，以及父母健康素养。儿童，特别是生活在贫困中的儿童，在童年时有过不良经历，容易受到有毒压力和各种儿童和成人健康问题的影响，包括发育迟缓、哮喘和心脏病。尽管社会决定因素对健康的不利影响，很少有儿童健康临床医生在常规初级保健访问过程中经常解决影响儿童及其家庭的未满足的社会和心理社会因素。临床医生需要工具来筛选健康的社会决定因素，并熟悉可用的地方和国家资源来解决这些问题。这些指南概述了影响贫困儿童健康的社会决定因素，并为临床医生提供了实用的筛查工具和资源。
Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources.