Examining the Impacts of Social Drivers of Health and Adverse Childhood Experiences in Children With Dermatological Disease: Part I: An Update and Review for Pediatric Dermatologists.

Abstract

Social drivers of health (SDH) are defined as the conditions in which people are born, live, learn, work, play, and age. These non-medical factors affect a wide range of health-related behaviors and outcomes and can be predictive of the development of chronic medical conditions. Moreover, having one or more negative SDH can influence the availability and feasibility of treatment options, as well as response to treatment. While research has increasingly shown that addressing SDH is critical to achieving optimal health outcomes for all patients across multiple fields of medicine, the field of dermatology is trailing behind other specialties in identifying and addressing SDH. Children face special barriers to care due to their relative inability to advocate for themselves and their increased likelihood of experiencing poverty, food insecurity, and housing insecurity in the United States. Many children also experience adverse childhood experiences (ACEs), and these traumatic stressors are associated with the development of chronic health conditions and diminished life expectancy. Numerous studies have demonstrated the effects of SDH and ACEs on the prevalence of and outcomes for common pediatric skin conditions, including atopic dermatitis, psoriasis, hidradenitis suppurativa, and acne vulgaris. Pediatric dermatologists should learn how to identify and screen for social risk in the clinical environment and know how to address these effectively in their practice to improve the health of all children.