Screening to Address Social Determinants of Health Among Young Children and their Families

Multiple bodies of research emphasize the critical need to address social determinants of health (SDOH), especially those that can have negative impact on the safety, stability, and nurturing of young children in the home environment. SDOH is one of six priority measurement priorities defined in the MCH MRN strategic measurement agenda .

Four domains of SDOH— material well-being , psychological well-being , social well-being , and relationship well-being —have been defined for young children through the efforts of the MCH MRN Social Determinants of Health Technical Working Group (TWG). (Download diagram. )

Currently, the field of child health is undergoing a transition toward greater focus on early and lifelong health, development, and well-being, which requires attention to social as well as medical determinants of health. Moreover, the recently released 4 ^th Edition of the American Academy of Pediatrics Bright Futures places greater emphasis on the role of well-child visits in identifying and responding to SDOH.

To fill an identified measurement gap, the MCH-MRN SDOH TWG developed an early childhood SDOH screening tool composed of 18 questions , which are based on analysis of other existing tools and questionnaires. While the MCH-MRN, and its sponsor MCHB/HRSA, are not endorsing it, this draft tool is available for testing and further analysis of its properties and utility. It is also being integrated into the CAHMI’s Well Visit Planner as appropriate to enrich the collection of SDOH information for well visits. ( www.wellvisitplanner.org )



The MCH-MRN SDOH TWG consensus report recognizes that the “why” and “how” are as essential as the “what” in screening for and responding to SDOH. Screening for SDOH is part of a relationship-centered process to engage parents (or other primary caregivers) and not an end in itself. The “why” of the screening tool is to anchor care on the context and needs of children and families and better partner with families in their role in the healthy development of their children. This engagement builds trust and opens new lines of communication between health providers and parents, ensuring they are connected to the supports they need and want. Simply put, any screening for SDOH represents a step in the process of supporting the family to promote the child’s health and development.

The MCH-MRN TWG strongly recommends further work to advance a comprehensive screening tool for use and adaptation in the field—starting with testing of the tool provided here and with an eye toward refinements. The MCH-MRN TWG also recommends that SDOH content inform future iterations of both the Bright Futures tools and the Well Visit Planner, which is well underway as noted above. Visi t www.cahmi.org to learn more about the Well Visit Planner.

Download Next Steps in Family Focused Screening to Address Social Determinants of Health for Young Children in Pediatric Primary Care : Report of the Social Determinants of Health (SDOH) Technical Working Group of the Maternal and Child Health Measurement Research Network (MCH-MRN) by Bruner, Johnson, Bethell, et al. The report includes the SDOH tool and background on its development.