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Social Determinants of Health Screening and Referral Project

Social determinants of health (SDoH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDoH screening/referral with a standardized tool is recommended in clinical encounters by the AAP and CMS.


ln the NICU,  SDoH screening and referral has increased in the out-patient pediatric setting, but has not yet come to scale in

the NICU. National survey study of NICUs indicates that national prevalence of SDoH screening/referral using a tool was 23% in 2021(Cordova Ramos et al, Hospital Pediatrics 2022).


This collaborative is starting out with 5 hospitals working towards the goal of identifying and addressing adverse social determinants of health in the neonatal setting. The 5 hospitals include Baystate Medical Center, Boston Medical Center, Lowell General Hospital, Tufts Medical Center, and UMass Memorial Medical Center. These hospitals were chosen due to a large proportion of low-income families with a need for SDH referrals. There is also a range of geographic location, combination of level 2 and 3 NICUs, and a range of discharge home vs. transfer to a level 2.'


The SDoH of interest to this project include, but are not limited to: housing,  food, transportation, energy/heat,  employment, education, childcare.


See past webinars here!

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