Caregiver stress and social determinants of health in key populations: immigrant parents, parents of children with medical complexity, and adolescent parents

Abstract

Purpose of reviewTo examine the five domains of social determinants of health – economic stability, education access, healthcare access and quality, neighborhood and built environment, and social and community context – and how these relate to caregiver stress in under-resourced populations.Recent findingsSocioeconomic and family factors are increasingly understood as drivers of child health. Caregiver stress can impact family stability and child wellbeing. Immigrant parents, caregivers of children with medical complexity, and adolescent parents experience stressors due to the unique needs of their families. These groups of parents and caregivers also face various challenges identified as social determinants of health. Interventions to mitigate these challenges can promote resilience, care coordination, and community-based supports.SummaryCurrent research describes caregiver stress in key populations, how caregiver stress affects children, and approaches to minimize and mitigate these effects. Pediatric providers can implement best practices to support families who are navigating stress due to caregiving and social determinants of health.

Perceived social support and characteristics of social networks of families with children with special healthcare needs following the COVID-19 pandemic

“…The authors concluded that this was most likely due to social support being less available for everyone as pandemic restrictions affected all families ( 16 ). Barriers in accessing community support for families with CSHCN have been described prior to the COVID-19 pandemic ( 3 ). It remains open whether our results still reflect the impact of the pandemic years on perceived social support of caregivers of CSHCN and future studies are thus needed as we move beyond pandemic recovery.…”

“…Financial stress and low SES have been described as associated with lower levels of perceived social support in adult populations ( 12 , 20 ). Families with CSHCN are particularly at risk of financial difficulties due to part-time work and resulting income loss, and an association of chronic disease and disability with low SES has been widely described ( 3 , 18 , 36 ). It is crucial that efforts to strengthen social support focus on this vulnerable group and aim to remove barriers to accessing support systems.…”

“…Children with special healthcare needs (CSHCN) have chronic health conditions which require more support than the average of their peers (1). Their families face multiple demands relating to the physical and mental wellbeing of the affected child, management of limited resources and to family functioning (2,3). As a result, caregivers of CSHCN are more likely to be affected by low levels of mental wellbeing, increased levels of stress, financial difficulties, social isolation and difficulties in accessing community resources (2)(3)(4).…”

Prediction of Adverse Events Risk in Patients with Comorbid Post- Traumatic Stress Disorder and Alcohol Use Disorder Using Electronic Medical Records by Deep Learning Models

“…Social determinants of health (SDoH) are “conditions or environments in which people are born, grow, live, work, and age,”( 8 ). Five key SDoH domains that have significant impacts on human health are (1) economic stability, (2) education, (3) health and health care, (4) neighborhood and built environment, and (5) social and community context( 9 ). Previous studies have focused on individual-level SDoH parameters and found improvement in financial status, employment status, access to healthcare, and community support systems have an increased likelihood of recovery.…”

On the Road to Understanding: Using Qualitative Research to Shape Trauma-Informed Pediatric Critical Care*

“…Additionally, the high proportion of parents of infants among the study population leads us to question the transferability of described themes to caregivers of older children. As prior studies have demonstrated an association between caregiver stress and various social determinants of health (12), it may be insightful to specifically investigate the role of social determinants of health in shaping the transport experience in future work. Although not a primary aim of the study by Evans et al (9), there is no discussion of the unique challenges encountered in transport medicine, including limited time, personnel, physical space, and available resources, as well as vehicle safety restrictions, all of which may practically limit the ability of transport teams to effectively enact interventions aimed at trauma-informed care.…”