New study finds relatively few hospital NICUs screen for social determinants of health

Credit: Unsplash/CC0 Public Domain

Social determinants of health (SDH) are the conditions in which people are born, grow, work, live and age that contribute to health outcomes across the lifespan. Adverse SDH, such as housing instability and food insecurity, occur more often among families living in poverty or near poverty and are associated with worse child health and health care utilization.

In 2016 the American Academy of Pediatrics (AAP) recommended for adverse SDH and referrals to community resources when needed at pediatric clinical care visits. However the extent to which these screenings occur in inpatient settings caring for high risk infants such as (NICUs) is unknown.

In what is believed to be the first study to examine the prevalence of standardized SDH and referral among a nationally representative sample of level 2 to 4 neonatal NICUs in the U.S., researchers from Boston University Chobanian & Avedisian School of Medicine found only 23 percent of NICUs had implemented this recommended practice.

"Given the extended opportunities for provider-family interaction over the prolonged neonatal hospitalization, this represents a missed opportunity to address the high burden of unmet social needs among families of high-risk infants," said first author Erika Cordova Ramos, MD, assistant professor of pediatrics.

The researchers randomly selected 100 hospitals with level 2 to 4 NICUs among each of the five U.S. regions and surveyed clinical leaders from January to November 2021 regarding standardized SDH screening. The higher the NICU level, the more comprehensive care (surgery) is provided to more seriously ill newborns.

Although many clinical leaders believed that addressing SDH was feasible, beneficial for infants and families and a priority for , less than one quarter of the units reported standardized SDH screening and referral processes.

According to the researchers, reported barriers to implementation included perceived lack of resources, inadequate referrals and lack of an inpatient screening tool. "Further investigation of optimal implementation strategies of SDH screening in U.S. NICUs is needed," added Cordova Ramos, who also is a neonatologist at Boston Medical Center.

These findings appear online in the journal Hospital Pediatrics.

More information: Erika G. Cordova-Ramos et al, National Prevalence of Social Determinants of Health Screening Among US Neonatal Care Units, Hospital Pediatrics (2022). DOI: 10.1542/hpeds.2022-006767

Citation: New study finds relatively few hospital NICUs screen for social determinants of health (2022, December 15) retrieved 27 February 2024 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Explore further

Too few hospitals have clinical decision support tools to calculate nutrition in NICU


Feedback to editors