Screening Children for Social Determinants of Health: A Systematic Review

Journal Article

CONTEXT: Screening children for social determinants of health (SDOHs) has gained attention in recent years, but there is a deficit in understanding the present state of the science. OBJECTIVE: To systematically review SDOH screening tools used with children, examine their psychometric properties, and evaluate how they detect early indicators of risk and inform care. DATA SOURCES: Comprehensive electronic search of PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection. STUDY SELECTION: Studies in which a tool that screened children for multiple SDOHs (defined according to Healthy People 2020) was developed, tested, and/or employed. DATA EXTRACTION: Extraction domains included study characteristics, screening tool characteristics, SDOHs screened, and follow-up procedures. RESULTS: The search returned 6274 studies. We retained 17 studies encompassing 11 screeners. Study samples were diverse with respect to biological sex and race and/or ethnicity. Screening was primarily conducted in clinical settings with a parent or caregiver being the primary informant for all screeners. Psychometric properties were assessed for only 3 screeners. The most common SDOH domains screened included the family context and economic stability. Authors of the majority of studies described referrals and/or interventions that followed screening to address identified SDOHs. LIMITATIONS: Following the Healthy People 2020 SDOH definition may have excluded articles that other definitions would have captured. CONCLUSIONS: The extent to which SDOH screening accurately assessed a child’s SDOHs was largely unevaluated. Authors of future research should also evaluate if referrals and interventions after the screening effectively address SDOHs and improve child well-being.

Full Text

Duke Authors

Cited Authors

  • Sokol, R; Austin, A; Chandler, C; Byrum, E; Bousquette, J; Lancaster, C; Doss, G; Dotson, A; Urbaeva, V; Singichetti, B; Brevard, K; Wright, ST; Lanier, P; Shanahan, M

Published Date

  • October 1, 2019

Published In

Volume / Issue

  • 144 / 4

Published By

Electronic International Standard Serial Number (EISSN)

  • 1098-4275

International Standard Serial Number (ISSN)

  • 0031-4005

Digital Object Identifier (DOI)

  • 10.1542/peds.2019-1622


  • en