Assessing social needs is key to helping children thrive

Updated 2 years ago on November 23, 2022

Food. housing. Safety.

We all understand that these are basic needs, and a growing body of research shows that they are crucial to a child's health. Abraham Maslow, a psychologist, presented a theory of human motivation in the 1940s. In his theory he described a hierarchy of needs, which we now know as Maslow's pyramid.

According to Maslow's system, needs at the lowest level must be met before needs at the next level can be fully met. The two lowest levels are physiological needs (food, clothing, shelter, sleep) and security needs (personal safety, employment resources, health).

Not surprisingly, these essential needs for human motivation are also essential for good health.

Social health needs, often referred to as social determinants of health, include poverty, food insecurity, lack of stable housing, and racism. The consequences for children who do not have these needs can haunt them throughout their lives.

Research shows that poverty can significantly affect educational attainment, risk-taking behavior, and employment later in life. Food insecurity can affect overall health and is associated with more emergency room visits, anxiety, and depression. Housing problems, whether lack of housing or substandard housing, have been independently associated with health outcomes such as hospitalizations, developmental risks, and overall health. Finally, racism may exacerbate these risks and consequences. Racism was also independently associated with increased mental health concerns, increased risk of stress-related illness, and other negative health outcomes.

Meeting social needs is critical to a child's ability to grow, develop and thrive. As a result, more and more health care providers are trying to identify and meet these needs in the health care office setting.

The most direct way to determine the needs of patients and families is simply to ask them about it. Social health needs assessments are increasingly being used, but collecting, storing, and using the information remains a challenge.

If a family fills out a questionnaire on paper and gives it to a nurse or medical assistant, what happens next? Do they fill out the same questionnaire at each visit? If questions are asked verbally during the collection of indicators or registration information, how are the answers recorded? What is the follow-up plan?

A recent study published in the journal Pediatric Quality and Safety found that the implementation of health-related social needs screening throughout the health care system using the electronic health record is a real and effective solution to these issues. This process increased compliance with screening in primary care, acute care, and specialty clinics from 0 to 70%.

Screening also increased the effectiveness of identifying and, most importantly, responding to these social needs. About 10% of patients screened had at least one social need; 3% had urgent needs that were addressed at this appointment. For those with non-urgent needs identified, 85% received counseling from social workers within a week of the appointment, and about 56% were resourced.

Using a tool that is part of almost every health care system, health care providers work together to meet the needs of the whole child and family. In doing so, they create the conditions for the child to live the healthiest and most successful life possible.

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