The impact of social determinants of health on the overall wellbeing of children: A review for the pediatric surgeon

Disparities in health care access, quality, and outcomes for pediatric patients, and their relationship to race and socioeconomic status (SES) have been extensively documented. The underlying causes behind such disparities have been less carefully studied, as clinicians and researchers often fail to look past im-mutable features such as race, into modifiable factors like social determinants of health (SDOH). A child's environment affects their patterns of social engagement, sense of security, and overall well-being. Re-sources such as affordable housing, access to education, public safety, and availability of healthy foods and safe play spaces impact and enhance quality of life, and have significant influence on both health and health care outcomes. These upstream indicators are often unrecognized or misidentified as health concerns. Few pediatric surgery publications discuss SDOH and their effects on children. This paper aims to introduce the five domains of SDOH (economic stability, education, social and community context, health and healthcare, and neighborhood and built environment) along with strategies to identify and address needs in these domains from a provider, hospital, and health system's perspective. It is antici-pated that this information will serve as a foundation for pediatric surgeons to understand and develop processes that ameliorate disparities related to SDOH and improve surgical outcomes and the well-being of all children.(c) 2021 Elsevier Inc. All rights reserved.

Automated summary

This article discusses the impact of race and socioeconomic status on healthcare access, quality, and outcomes for pediatric patients. It highlights the importance of social determinants of health and introduces the five domains of social determinants of health that affect children. The article also provides strategies for identifying and addressing needs in these domains from the perspective of healthcare providers, hospitals, and health systems, with the goal of improving surgical outcomes and the well-being of all children.