Role of Effective Policy and Screening in Managing Pediatric Nutritional Insecurity as the Most Important Social Determinant of Health Influencing Health Outcomes

Author:

Verma Hema1ORCID,Verma Arun2ORCID,Bettag Jeffery2ORCID,Kolli Sree2,Kurashima Kento2ORCID,Manithody Chandrashekhara2ORCID,Jain Ajay2

Affiliation:

1. SLU College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA

2. Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA

Abstract

Social Determinants of Health (SDOH) impact nearly half of health outcomes, surpassing the influence of human behavior, clinical care, and the physical environment. SDOH has five domains: Economic Stability, Education Access and Quality, Health Care Access and Quality, Neighborhood and Built Environment, and Social and Community Context. Any adversity arising out of these interlinked domains predominantly affects children due to their greater susceptibility, and the adverse outcomes may span generations. Unfavorable SDOH may cause food insecurity, malnutrition, unbalanced gut microbiome, acute and chronic illnesses, inadequate education, unemployment, and lower life expectancy. Systematic screening by health care workers and physicians utilizing currently available tools and questionnaires can identify children susceptible to adverse childhood experiences, but there is a deficiency with respect to streamlined approach and institutional support. Additionally, current ameliorating supplemental food programs fall short of pediatric nutritional requirements. We propose a nutrition-based Surveillance, Screening, Referral, and Reevaluation (SSRR) plan encompassing a holistic approach to SDOH with a core emphasis on food insecurity, coupled with standardizing outcome-based interventions. We also propose more inclusive use of Food Prescription Programs, tailored to individual children’s needs, with emphasis on education and access to healthy food.

Funder

National Institutes of Health

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

Reference42 articles.

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3. Whitman, A., De Lew, N., Chappel, A., Aysola, V., Zuckerman, R., and Sommers, B.D. (2023, June 12). Addressing Social Determinants of Health: Examples of Successful Evidence-Based Strategies and Current Federal Efforts, Available online: https://aspe.hhs.gov/reports/sdoh-evidence-review.

4. Health Research & Educational Trust (2017). Social Determinants of Health Series: Food Insecurity and the Role of Hospitals, American Hospital Association. Available online: https://www.aha.org/ahahret-guides/2017-06-21-social-determinants-health-series-food-insecurity-and-role-hospitals.

5. Provider and Staff Feedback on Screening for Social and Behavioral Determinants of Health for Pediatric Patients;Byhoff;J. Am. Board Fam. Med.,2019

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