Social Drivers of Health Resources for Pediatricians

There are several factors that impact child health that should be considered in identifying, diagnosing, and treating developmental-behavioral issues. Social drivers of health, childhood toxic stress, and racism impact both development and functioning.  

Almost half of young children in the United States live in poverty or near poverty. Poverty and related social drivers of health (SDHs) can lead to adverse health outcomes in childhood and across the life course, negatively affecting physical and mental health, socioemotional development, and educational achievement.   

SDHs are the conditions in which people are born, live, work, and age that influence their health outcomes.  Research has shown these non-medical factors, including poverty, education, healthcare access, and neighborhood environment, can influence 80% of health and health care outcomes, including mortality, life expectancy, and health status. Thus, there is no way to deliver comprehensive, holistic, and sensitive health care without delving into and understanding the challenges patients and their families face. Addressing SDHs can occur at preventive, acute, and emergency visits; during hospitalizations; and in early childhood community programs like Head Start and home visiting. 

Trauma-Informed Pediatric Care 

Many children and families have experienced trauma – whether that is trauma that occurs within the household, like substance abuse, parental mental illness, abuse or neglect; or trauma that occurs in the community, like community violence, poverty and others. Pediatricians may not always know which of their patients and families have experienced trauma – that’s whay the AAP recommends trauma-informed care as a universal approach to pediatric care.  
 
Trauma-informed care, as defined by Hopper and colleagues, is a "strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, and emphasizes the physical, psychological, and emotional safety for both providers and survivors, and creates opportunities for survivors to build a sense of control and empowerment." 

Pediatricians and other pediatric health care professionals are uniquely positioned to partner with families to identify and respond to trauma in children and adolescents. They need to be prepared to:  

• Promote safe, stable, nurturing relationships
• Recognize signs of traumatic stress
• Assess symptoms 
• Treat when needed 

TIC is fundamentally relational health care -  the ability to form safe, stable and nurturing relationships (SSNRs). Pediatricians can support the caregiver-child relationship, the context in which there can be recovery from trauma and the restoration of resilience. 

This resource was made possible through the generous support of AAP donors to the Friends of Children Fund.