Reductions In Hospitalizations Among Children Referred To A Primary Care–Based Medical-Legal Partnership

Beck, Andrew F.; Henize, Adrienne W.; Qiu, Tingting; Huang, Bin; Zhang, Yin; Klein, Melissa; Parrish, Donita S.; Fink, Elaine; Kahn, Robert S.

doi:10.1377/hlthaff.2021.00905

Cited by 31 publications

(29 citation statements)

References 43 publications

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“…A review by Gottlieb et al [68] identified 37 programs aimed at addressing family social and economic needs, but these evaluations were largely focused on process measures like referral rate and effect on social determinants of health rather than health outcomes, utilization, or cost [69]. For example, whereas screening for health-harming legal needs and referral to medical–legal partnerships has been associated with positive legal outcomes and improvements in social determinants of health, studies linking this process to decreased acute healthcare utilization and health outcomes are limited [70 ▪ ,71,72 ▪ ]. Although larger scale intervention studies are underway, a standardized approach to evaluation, particularly in pediatrics, is still lacking [73].…”

Section: Health Outcomes and Valuementioning

confidence: 99%

Social determinants of health screening in pediatric healthcare settings

Nerlinger

Kopsombut

2022

Current Opinion in Pediatrics

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Purpose of reviewThis article outlines updates in social determinants of health (SDOH) screening practices in pediatric healthcare and community settings. The transition to value-based care and the COVID-19 pandemic have both had significant impacts on screening practices, with implications for providers, communities, and policymakers.Recent findingsThe COVID-19 pandemic has exacerbated social needs for vulnerable patients and families, resulting in increased recognition by healthcare teams through screening. Policy frameworks like value-based care that aim to deliver whole-child care in the community are reorienting the logistics of screening, including screening in acute-care settings and community settings. Recent studies on family and provider perspectives should be integrated into screening practices.SummaryDespite significant advances in and expansion of SDOH screening in the pediatric healthcare setting, there remain limitations and future research needs. More data is needed to evaluate social need screeners and interventions, and determine how healthcare systems, communities, and states can spread and scale such interventions based on outcomes and value measurements. Population-based social indices have the potential to augment individual patient screening, but this remains a future research need.

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Section: Health Outcomes and Valuementioning

confidence: 99%

Social determinants of health screening in pediatric healthcare settings

Nerlinger

Kopsombut

2022

Current Opinion in Pediatrics

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“…Survey data from more than 1000 families conducted in April 2020 revealed that 76% reported concerns of financial stability, 43% about employment, 31% about housing stability, and 36% about healthcare access. [15] In our patient population with pre-pandemic socioeconomic disadvantage, [16] we postulate that the increased social and economic burdens families faced during the pandemic could have influenced access to and priority for receiving influenza vaccinations. Although we did not identify an association between reported social risks and influenza vaccination, this could be due to the relatively high rates of risks present within our population.…”

Section: Discussionmentioning

confidence: 99%

Declining influenza vaccination rates in an underserved pediatric primary care center during the COVID-19 pandemic

Day

Klein²,

Sucharew³

et al. 2022

Vaccine

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“…Clinicians are uniquely poised to identify patients at risk of eviction and make referrals to public and community-based solutions. Screening and referral can improve outcomes associated with housing and child health, and various screening measures related to housing are validated for clinical practice . Given that many clinicians feel uncertain about how to address material hardship among patients, systematic protocols could empower clinicians to efficiently connect patients with local legal and housing resources …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…63,64 Given that many clinicians feel uncertain about how to address material hardship among patients, 65 systematic protocols could empower clinicians to efficiently connect patients with local legal and housing resources. 62,63,65,66 Health care systems can also bolster programs to support families with unexpected and chronic medical needs. For example, prospective research from the FFCWS found that infants in rental housing at the study's baseline who had experienced an adverse birth outcome had an elevated risk of eviction through age 5 years.…”

Section: Implications For Practice and Policymentioning

confidence: 99%

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Evictions and Infant and Child Health Outcomes

et al. 2023

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ImportanceMillions of rental evictions occur in the United States each year, disproportionately affecting households with children. Increasing attention has been paid to the impact of evictions on child health outcomes.ObjectiveTo synthesize and assess studies examining the associations of eviction exposure with infant and child health outcomes.Evidence ReviewFor this systematic review without meta-analysis, a database search was performed using PubMed, Web of Science, and PsycINFO, through September 25, 2022. Included studies were peer-reviewed quantitative studies examining an association between exposure to eviction and at least 1 health outcome, both before age 18 years, including prenatal exposures and perinatal outcomes. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data were analyzed from March 3 to December 7, 2022.FindingsDatabase searches identified 266 studies, and 11 studies met inclusion criteria. Six studies examined associations between prenatal eviction and birth outcomes, such as gestational age, and each found that eviction was significantly associated with at least 1 adverse birth outcome. Five studies investigated other childhood outcomes, including neuropsychological test scores, parent-rated child health, lead testing rates, and body mass index, and among these 5 studies, 4 reported an association between eviction and adverse child health outcomes. Direct experience of eviction or residence in a neighborhood with more evictions was associated with adverse perinatal outcomes in 6 studies, higher neurodevelopmental risk in 2 studies, worse parent-rated child health in 2 studies, and less lead testing in 1 study. Study designs and methods were largely robust.Conclusions and RelevanceIn this systematic review without meta-analysis of the association between evictions and child health outcomes, evidence demonstrated the deleterious associations of eviction with a range of developmental periods and domains. In the context of a rental housing affordability crisis, ongoing racial disparities in evictions, and continuing harm to millions of families, health care practitioners and policy makers have an integral role to play in supporting safe, stable housing for all.

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Reductions In Hospitalizations Among Children Referred To A Primary Care–Based Medical-Legal Partnership

Cited by 31 publications

References 43 publications

Social determinants of health screening in pediatric healthcare settings

Social determinants of health screening in pediatric healthcare settings

Declining influenza vaccination rates in an underserved pediatric primary care center during the COVID-19 pandemic

Evictions and Infant and Child Health Outcomes

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