Assessing Health Risks in Children and Adolescents in Pediatric Care: Let’s Not Forget Social Determinants of Health by Jeanne M Cartier in Progressing Aspects in Pediatrics and Neonatology in Lupine publishers
Within the practice of pediatric medicine, a family and
social history has historically been a part of the assessment of
children. However, the scope of said history was usually limited
to understanding the family composition, family health history
and developmental behavior and activities of the child. Ongoing
advances in basic and clinical sciences have increased knowledge
of underlying disease etiology, including the role of genetics
and genomics, brain physiology and immune functioning in
disease origins and development, have led to the discovery of
new and effective pharmacological agents and have informed
the development of evidenced based treatment protocols. These
advances have clearly improved treatment of existing diseases
and conditions. There has also been advances in understanding
the role of social factors as contributors to both immediate and
long term health outcomes for patients throughout childhood and
reaching into adulthood. Medical care as well as genetics, social
circumstances, behavior, environmental and physical influences
have been defined as the major determinants of health [1]. While
access to medical care and clinical care contribute to health
outcomes, more than 80% of the health outcomes are attributable
to health behaviors as well as social and environmental factors [2].
Pediatrics is well situated to take the lead for including a broader
and more robust social history to deepen our understanding,
assessment and treatment of these risk factors.
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