New research led by Meg Parker, MD, MPH, Child Health Equity Center Core Faculty, found that Neonatal Intensive Care Units (NICUs) across the U.S. are inconsistent in how they address adverse social determinants of health among patients and families and that few NICUs are actively screening for social determinants of health.
Study of Social Determinants of Health in NICU Settings
Adverse social determinants such as economic instability, limited education attainment, unstable living environment, and limited healthcare access can have detrimental consequences to health and well-being both in the short and long term.
To mitigate the effects of adverse social determinants of health, it is important to screen patients and families during both outpatient and inpatient visits. Because infants who require extended stays in the NICU represent a uniquely vulnerable population, it is vital that NICU families are actively screened for adverse social determinants of health and referred to appropriate resources.
Meg Parker, MD, MPH, a national leader in addressing social risks in the NICU, along with Arvin Garg, MD, MPH, Larry Rhein, MD, MPH and colleagues, conducted a mixed methods study in safety-net NICUs in Massachusetts to better understand how NICUs’ treatment of primarily low-income patients addresses patients social needs.
Findings of Social Determinants of Health in NICU Settings
While some NICU providers were screening for adverse social determinants of health, these screenings were inconsistent and often focused only on one or two domains. Specifically, parents’ employment status was often collected while other needs (e.g., childcare, food, housing, transportation, and utilities) were more frequently neglected. Fortunately, in cases where needs were assessed, there was a higher rate of need identification.
NICU providers who were interviewed as part of the study expressed the need for standardized social determinants of health screening in the NICU. One physician stated, “In pediatrics, you don’t treat only the patient, you end up treating the family.” To fully support the needs of pediatric patients, providers must understand the circumstance in which the patient lives.
Steps to Addressing Social Determinants of Health in NICU Settings
Standardizing social determinants of health screening in the NICU has the potential to improve health equity. With increased screening, families who identify needs can be linked to community resources able to meet their needs and connected with social workers who can help them navigate these resources.
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About the Authors
Jason Li is a Child Health Equity Center Intern. He is currently pursuing a Bachelor’s of Science in Human Physiology with a minor in Public Health at Boston University.
Alison LeBlanc, MS, PMP, is Executive Director of the Child Health Equity Center and a staunch advocate of hospital screening for social determinants of health .