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American Academy of Pediatrics
Article

Screening for Poverty and Poverty-Related Social Determinants of Health

Rachel Stein Berman, Milani R. Patel, Peter F. Belamarich and Rachel S. Gross
Pediatrics in Review May 2018, 39 (5) 235-246; DOI: https://doi.org/10.1542/pir.2017-0123
Rachel Stein Berman
*Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
†Division of Academic General Pediatrics, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY
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Milani R. Patel
*Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
†Division of Academic General Pediatrics, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY
‡Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY
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Peter F. Belamarich
*Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
†Division of Academic General Pediatrics, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY
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Rachel S. Gross
*Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
†Division of Academic General Pediatrics, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY
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This article has a correction. Please see:

  • CME Quiz Clarification - July 01, 2018

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  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
  • AUTHOR DISCLOSURE

    Drs Berman and Patel have disclosed no financial relationships relevant to this article. Dr Belamarich has disclosed that he serves as site investigator for Centers for Disease Control and Prevention (CDC) grant 6 NH23IP000950-03-01, a multisite human papillomavirus vaccination performance improvement project. Dr Gross has disclosed that she serves as site principal investigator for the National Institutes of Health/National Institute of Child Health and Human Development through K23 Mentored Patient-Oriented Research Career Development Award K23HD081077. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

  • 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
  • Practice Gap

    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.

    Objectives

    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.

    Case Scenario

    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. …

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    Pediatrics in Review: 39 (5)
    Pediatrics in Review
    Vol. 39, Issue 5
    1 May 2018
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    Screening for Poverty and Poverty-Related Social Determinants of Health
    Rachel Stein Berman, Milani R. Patel, Peter F. Belamarich, Rachel S. Gross
    Pediatrics in Review May 2018, 39 (5) 235-246; DOI: 10.1542/pir.2017-0123

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    Screening for Poverty and Poverty-Related Social Determinants of Health
    Rachel Stein Berman, Milani R. Patel, Peter F. Belamarich, Rachel S. Gross
    Pediatrics in Review May 2018, 39 (5) 235-246; DOI: 10.1542/pir.2017-0123
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    • Article
      • Practice Gap
      • Objectives
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