Social Determinants of Health Social Determinants of Health Browse the resources on this page for information and tools on screening, referral, and follow-up for social determinants of health and managing psychosocial concerns. Advertising Disclaimer AAP Resources: Screening, Referral, and Follow-up Policy, Guidelines, and Publications Early Childhood Adversity, Toxic Stress, & the Role of the Pediatrician: Translating Developmental Science into Lifelong Health (2012) – Policy statement providing an overview of how a child’s environment interacts with biological predispositions to affect lifelong physical and mental health. Discusses how to meld early identification of developmental concerns with interventions to reduce threats to healthy brain growth. Mediators and Adverse Effects of Child Poverty in the United States (2016) – Technical report describing current evidence on the impact of poverty on child health and development. Poverty and Child Health in the United States (2016) – Policy statement discussing the impact of poverty on child health and ways in which pediatricians can help mitigate the effects of poverty, both for individual patients and through broader advocacy. Promoting Food Security for All Children (2015) – Policy statement providing guidance on how pediatricians can play a key role in screening and identifying children at risk for food insecurity, connecting families with needed community resources, and advocating for federal and state policies supporting access to healthy food. The Evaluation of Suspected Child Physical Abuse (2015) – Policy statement on the role that pediatricians play in identifying suspicious injuries, reporting physical abuse to the proper authorities, supporting affected families, and coordinating with resources in the community to provide immediate and long-term care for the child. The Lifelong Effects of Early Childhood Adversity and Toxic Stress (2016) – Report presenting an ecobiodevelopmental framework that shows how early experiences can impact genetic predispositions that affect brain architecture and long-term health outcomes. Tools, Trainings, and Other ResourcesAddressing Food Insecurity: A Toolkit for Physicians - Toolkit providing guidance on incorporating the food screening process into practice workflow, choosing the right tool, and intervening to help address food insecurity.Feelings Need Check-ups Too Toolkit - Toolkit informing pediatricians about crisis-related mental health problems, demonstrating the use of various screening tools through a case study approach, and providing information on other needs such as parental reassurance and bereavement support.Peds-21: The Trauma-Informed Pediatrician: Identifying Toxic Stress and Promoting Resilience - Recordings from the American Academy of Pediatrics 2015 Peds-21 symposium explaining how pediatric health care providers can identify and address toxic stress in their patients and access resources to promote resilience.Poverty and Child Health - AAP resources on the impact of poverty on children's health, including practice tips and advocacy ideas.The Resilience Project - Resources assisting pediatric health care providers in building resilience in children exposed to trauma, including a training toolkit, practice and provider resources, assessment tools, and past webinars.Toxic Stress and Resilience Video Series: Health Care Professionals - Video for educating pediatric health care providers about the effects of toxic stress on children and how to help prevent it.Trauma Toolbox for Primary Care (2014) - Series designed to assist pediatric health care providers with the process of asking families about exposure to adverse childhood experiences or other traumatic events.AAP Resources: Diagnosis and Management Addressing Mental Health Concerns in Primary Care: A Clinician’s Toolkit (2010) –Includes quick-reference care management advice, step-by-step care plans, time-saving documentation and referral tools, coding aids, billing and payment tips, parent handouts, and community resource guides. The Evaluation of Children in Primary Care Setting When Sexual Abuse is Suspected (2005, Reaffirmed 2013) – Outlines the role of the physician in reporting suspected sexual abuse and assessing the physical, emotional and behavioral consequences. Implementing Mental Health Priorities in Practice: Motivational Interviewing – Brief video offering guidance on how to conduct a motivational interview in a short time period. Implementing Mental Health Priorities in Practice: Social and Emotional Problems – Brief video on using motivational interviewing to identify and address social emotional problems in children birth to 5 years of age. Report from the AAP Task Force on Mental Health (2010) – Outlines strategies to enhance mental health at both the community level and in individual pediatric practices. Also provides clinical algorithms to guide pediatric health care providers through the process of implementing mental health care into practice.Section on Child Abuse and Neglect – Offers numerous policies and publications on the evaluation and management of abuse and neglect..External ResourcesAmerican Academy of Family Physicians - Organization presenting policy statements including those on Child Abuse and Intimate Partner Violence (IPV), which discusses the various forms of IPV and the unique role that primary care physicians have in breaking the cycle through screening patients.Avoiding the Unintended Consequences of Screening for Social Determinants of Health - Article providing guidance on avoiding the potential harms of social determinants screening.Beyond the Beside: Social Determinants of Health Curriculum and Assessment in the Health Professions - Webinar outlining how community-based experiences and simulation-based learning can impact educational outcomes and enhance health professions training in the social and economic factors that influence health.Center for the Study of Social Policy - Organization working toward equal opportunity for children and families with several relevant projects and publications, including:Working Toward Well-Being: Community Approaches to Toxic Stress - Report highlighting community-level strategies to prevent and ameliorate the effects of toxic stress.Center on the Developing Child, Harvard University - Multidisciplinary center offering information on early childhood development with a focus on toxic stress and resilience, such as Toxic Stress Derails Healthy Development and The Science of Early Childhood Development: Closing the Gap Between What We Know and What We Do.Changing Minds - Web site from Defending Childhood that provides stories about the impact of violence on a child's brain and how five gestures from a caring adult can make a difference.Data Resource Center for Child and Adolescent Health - Searchable database for state and national-level ACEs data; presented by the Child and Adolescent Health Measurement Initiative (CAHMI).Screening for Social Determinants of Health - Webinar on screening for social determinants, including the Health Begins Upstream Risk Screening Tool and the Dayton Children's Family Resource Connection questionnaire; presented by the Children's Hospital Association.Early Childhood Trauma - Report regarding the importance of identifying the impact that trauma has on the development of children, symptoms of trauma, and identifying and providing services to children that display these.Futures Without Violence - Organization advocating to end violence against women and children; provides webinars on trauma-informed practice.Health Barriers to Learning - Report describing the Health Barriers to Learning, many of which are the result of adverse childhood experiences, and the supporting evidence base for their impact on academic success. This report offers parents, practitioners and policymakers in the healthcare, education and children's services sectors recommendations to strengthen and integrate the safety net for children.Health Leads - Organization assisting health care providers with connecting families with basic resource needs; includes a Social Needs Screening Toolkit providing guidance on screening for social determinants of health as well as best practices for screening, recommended tools, and a question library.Help Me Grow National Center - Connects at-risk children to the services they need, with affiliates in 25 states; the Center's publication Supporting Infants, Toddlers, and Families Impacted by Caregiver Mental Health, Substance Abuse, and Trauma is a community resource guide for pediatric health care providers.More Precisely Targeting the Coal Mine of Social Adversity (2016) - Article discussing the evidence found in the Effects of Social Needs Screening and In-Person Navigation on Child Health (2016) study, which examines a relatively low-cost social needs intervention.Improving the Odds for Young Children - Project by the National Center for Children in Poverty working to aggregate data on state efforts to support the health of young children; users can view and compare state early childhood policy profiles as well as calculate risk using the Young Child Risk Calculator.Medical-Legal Partnership Toolkit - Guide directing health care practitioners and legal institutions through the process of coordinating care and developing a medical-legal partnership, presented by the National Center for Medical-Legal Partnership.New Guide for Providing a Trauma-Informed Approach in Human Services - Guide introducing the topic of trauma; includes a discussion of why understanding and addressing trauma is important for human services programs, and a "road map" to find relevant resources.Social Determinants of Health: A Toolkit for Collaboration - Toolkit aiming to bring together representatives from multiple sectors to address social determinants of health.Stop. Look. Listen - Training for pediatric health care providers that focuses on identifying child abuse and maltreatment (CME available).Substance Abuse and Mental Health Services Administration - Web site offering various publications and initiatives regarding the impact of trauma such as:Concept of Trauma and Guidance for a Trauma-Informed Approach - Report providing information on trauma-informed care.National Child Traumatic Stress Initiative - Resources for parents, caregivers, and pediatric health care providers on recognizing and responding to child trauma.Support Infants, Toddlers, and Families Impacted by Caregiver Mental Health Problems, Substance Abuse and Trauma: A Community Action Guide - Report highlighting the importance of the birth to five period and threats to optimal growth and development.A Toolkit for the Well Child Screening of Military Children - Toolkit designed to assist members of the pediatric care team in identifying military families, assessing distress levels, and connecting families to supportive resourcesVeto Violence - CDC Web site featuring a multitude of practice resources such as fact sheets, infographics, and tools and trainings regarding various types of violence including child abuse and intimate partner violenceResources Specific to Resilience and Protective FactorsBalancing Adverse Childhood Experiences (ACEs) With HOPE - Report presenting evidence for HOPE (Health Outcomes of Positive Experiences) based on newly released data that reinforce the need to promote positive experiences for children and families in order to foster healthy childhood development.Building Resilience - Report from ZERO TO THREE providing suggestions for building resilience in parents.Center for the Study of Social Policy - Organization working toward equal opportunity for children and families with several relevant projects and publications, including:Parental Resilience: Protective and Promotive Factors - Tip sheets explaining protective factors and offering suggestions for engaging parents around each factor (includes what to look for and questions to elicit strengths).Strengthening Families: A Protective Factors Framework - Framework providing a research-informed approach to increase family strengths, enhance child development and reduce the likelihood of child abuse and neglect.Primary Health Partners Promoting Children's Health and Resiliency: A Strengthening Families Approach - Tip sheet directed towards helping pediatric health care providers use the protective factors model to recognize child and family strengths as well as identify and assist children impacted by trauma; reviews the 5 protective factors and includes questions that pediatric health care providers might ask parents to begin discussions around trauma and the protective factors.Promoting First Relationships in Primary Care - Program presented by NCAST (Nursing Child Assessment Satellite Training) designed to help pediatric primary care providers support stable and secure early parent-child relationships.Resources Specific to Adverse Childhood Experiences (ACEs)Addressing the Bigger Picture in Pediatric Settings: Adverse Childhood Experiences - Course providing an introduction to ACEs and their impacts on children and families, resiliency, and implementing a trauma-informed approach into pediatric care settings (CME credit available).Adverse Childhood Experiences: National and State Level Prevalence - Research brief describing the prevalence of ACEs presented by Child Trends.Center for Youth Wellness - Offering information on Why and How We Screen for ACEs, including a screening tool developed by the Center to measure childhood exposure to ACEs.Maternal and Child Health Bureau - Federal agency working to improve the health of mothers, children, and families through evidence-based, data-driven programming, including the Child Health and Adverse Childhood Experiences: Implications for the Medical Home research project to develop an ACEs screening tool, information sheets for pediatric health care providers, and recommendations for the medical home.Resources Specific to Homelessness, Food Insecurity, and Economic HardshipACF Office of Family Assistance - Web site providing information on federal grant programs that foster family economic security and stability, including the Temporary Assistance for Needy Families (TANF) program.ACF Programs and Services for Homelessness - Webpage providing resources for those who are homeless or at risk for homelessness as well as information on topics such as family homelessness, early care and education for homeless children, and domestic violence and homelessness.America's Youngest Outcasts: A Report Card on Child Homelessness - Web site offering statistics, nationally and by state, on family homelessness and its impact on young children; includes causes of child homelessness and opportunities for intervention and prevention.Clinicians' Perceptions of Screening for Food Insecurity in Suburban Pediatric Practice - Study evaluating the feasibility, acceptability, and impact of screening for food insecurity in suburban practices.Cultivating Healthy Communities: Lessons from the Field on Addressing Food Insecurity in Health Care Settings - Publication from Children's HealthWatch offering ideas for addressing food insecurity in the health care setting and highlighting best practices for success.USDA Food Security Tools - Web site offering tools that screen for food insecurity; includes a tool available in Spanish.Suburban Families' Experience With Food Insecurity Screening in Primary Care Practices - Study providing greater understanding of parents' experiences of food insecurity (FI) in suburban settings in order to effectively screen and address FI in suburban practices.Special PopulationsHealth and Mental Health Needs of Children in US Military Families (2013) –Guidance on caring for military children whose loved ones have been, are, or will be deployed.Helping Foster and Adoptive Parents Cope with Trauma – Documents discussing how pediatricians can help foster and adoptive parents to understand the special needs of their child.Immigrant Child Health Toolkit – Provides practical information and resources for addressing matters related to immigrant child health. Information about clinical care, immigration status, access to care, mental health and state resources for immigrant children and families is included.Maltreatment of Children with Disabilities (2007, reaffirmed 2011) – Policy statement on early recognition of and intervention for child abuse and neglect among children with disabilities.Providing Care for Children and Adolescents Facing Homelessness and Housing Insecurity (2013) – Describes how pediatricians can optimize the health and well-being of children who are homeless.Psychosocial Implication of Disaster or Terrorism on Children: A Guide for the Pediatrician (2005, reaffirmed 2015) – Report discussing how to advocate for children and families at the community level as well as guidance on how to ameliorate the effects of disaster on children.Supporting the Grieving Child and Family (2016) – Report offering suggestions on how to talk with grieving children and resources for professional preparation and self-care.