From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

Fatima Fazalullasha¹, Jillian Taras², Julia Morinis³, Leo Levin⁴, Karima Karmali⁵, Barbara Neilson⁶, Barbara Muskat⁶, Gary Bloch⁷, Kevin Chan⁸, Maureen McDonald⁹, Sue Makin¹⁰, E Lee Ford-Jones¹¹

Affiliations

¹ Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto; ; Faculty of Medicine, University of Ottawa, Ottawa;
² Faculty of Medicine, University of Toronto;
³ Departments of Pediatric Medicine, The Hospital for Sick Children;
⁴ Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto; ; The Children's Aid Society;
⁵ Child and Family Relations Center for Innovation and Excellence in Child and Family-Centered Care, The Hospital for Sick Children;
⁶ Department of Social Work, The Hospital for Sick Children and University of Toronto;
⁷ Family Medicine, The Hospital for Sick Children and Munk Centre for Global Studies, University of Toronto;
⁸ Department of Emergency Medicine, The Hospital for Sick Children and Munk Centre for Global Studies, University of Toronto;
⁹ Mothercraft, Toronto, Ontario.
¹⁰ Toronto Public Health, Toronto, Ontario.
¹¹ Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto;

PMID: 24855416
PMCID: PMC4028645
DOI: 10.1093/pch/19.4.195

Review

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

Fatima Fazalullasha et al. Paediatr Child Health. 2014 Apr.

. 2014 Apr;19(4):195-9.

doi: 10.1093/pch/19.4.195.

Authors

Affiliations

¹ Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto; ; Faculty of Medicine, University of Ottawa, Ottawa;
² Faculty of Medicine, University of Toronto;
³ Departments of Pediatric Medicine, The Hospital for Sick Children;
⁴ Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto; ; The Children's Aid Society;
⁵ Child and Family Relations Center for Innovation and Excellence in Child and Family-Centered Care, The Hospital for Sick Children;
⁶ Department of Social Work, The Hospital for Sick Children and University of Toronto;
⁷ Family Medicine, The Hospital for Sick Children and Munk Centre for Global Studies, University of Toronto;
⁸ Department of Emergency Medicine, The Hospital for Sick Children and Munk Centre for Global Studies, University of Toronto;
⁹ Mothercraft, Toronto, Ontario.
¹⁰ Toronto Public Health, Toronto, Ontario.
¹¹ Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto;

PMID: 24855416
PMCID: PMC4028645
DOI: 10.1093/pch/19.4.195

Abstract
in English, French

Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.

Des recherches antérieures ont fait ressortir l’importance de tenir compte des déterminants sociaux de la santé pour améliorer la santé des enfants. Cependant, des obstacles importants empêchent les pédiatres de bien se pencher sur la question, incluant le manque de temps clinique, de ressources, de formation et d’enseignement sur les déterminants de la santé, la connaissance des ressources communautaires et la capacité de gestion des cas. Les recommandations faites en pratique générale pour aider le dispensateur de soins à orienter les patients vers des ressources communautaires ne suffisent pas. Le présent article vise à présenter des moyens de faire de meilleurs liens entre le cabinet et la communauté, à l’aide de questions de dépistage intégrant des outils médicaux qui dirigent les patients vers des ressources communautaires. Des interventions simples, telles que l’orientation systématique vers des centres de la petite enfance et l’orientation sélective vers des programmes de visite à domicile par la santé publique, peuvent contribuer à servir les populations qui ont les besoins les plus criants.

Keywords: Health care delivery; Paediatrics; Social determinants of health.

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References

1. Marmot M, Friel S, Bell R, Houweling T, Taylor S, Commission on Social Determinants of Health Closing the gap in a generation: Health equity through action on the social determinants of health. Lancet. 2008;371:1661–9. - PubMed
1. Gupta RP, de Wit ML, McKeown D. The impact of poverty on the current and future health status of children. Paediatr Child Health. 2007;12:667–72. - PMC - PubMed
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1. Campaign 2000 . Revisiting family security in insecure times: 2011 report card on child and family poverty in Canada. Toronto: Family Service Toronto; 2011.
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From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

Affiliations

From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice

Authors

Affiliations

Abstract
in English, French

References

Publication types

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Abstract in English, French

References

Publication types

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Abstract
in English, French