Less than a quarter of NICUs conduct social determinants of health screenings

Less than 25 percent of neonatal intensive care units across the U.S. screen for universal social determinants of health, according to a study published Nov. 1 in Hospital Pediatrics.

The American Academy of Pediatrics' universal screening recommendations, issued in 2016, provide guidelines for how clinicians should approach families during routine pediatric clinical visits when social determinants of health — including housing and food insecurity — are suspected. Further, the AAP suggested these families be referred to community resources as appropriate.  

However, a longer stay in a NICU provides physicians with time to address potential concerns. According to study researchers from Boston University Chobanian and Avedisian School of Medicine, only 23 percent of NICUs routinely screen for social determinants of health. 

"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," Dr. Erika Cordova Ramos, neonatologist, assistant professor of pediatrics and first author of the study, said in a Dec. 15 news release.

Many physicians at the 100 level 2 to 4 NICUs included in the study from across the U.S. said it was feasible to conduct social determinants of health screenings, and said they believed doing so should be prioritized in NICUs because of the ultimate benefit community resource referrals would have on needy families.

Clinician leaders surveyed throughout the U.S. from January to November 2021 said screenings were not being conducted because of a perceived lack of community resources and lack of an inpatient screening tool.

"Further investigation of optimal implementation strategies of SDH screening in US NICUs is needed," Dr. Cordova Ramos said.

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