title: From office tools to community supports: The need for infrastructure to address the social determinants of health in paediatric practice.
abstract: Previous research has highlighted the importance of addressing the social determinants of health to improve child health outcomes. However, significant barriers exist that limit the paediatrician's ability to properly address these issues. Barriers include a lack of clinical time, resources, training and education with regard to the social determinants of health; awareness of community resources; and case-management capacity. General practice recommendations to help the health care provider link patients to the community are insufficient. The objective of the current article was to present options for improving the link between the office and the community, using screening questions incorporating physician-based tools that link community resources. Simple interventions, such as routine referral to early-year centres and selected referral to public health home-visiting programs, may help to address populations with the greatest needs.
authors.affiliation: Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto; ; Faculty of Medicine, University of Ottawa, Ottawa;
authors.forename: Fatima
authors.initials: F
authors.lastname: Fazalullasha
authors.affiliation: Faculty of Medicine, University of Toronto;
authors.forename: Jillian
authors.initials: J
authors.lastname: Taras
authors.affiliation: Departments of Pediatric Medicine, The Hospital for Sick Children;
authors.forename: Julia
authors.initials: J
authors.lastname: Morinis
authors.affiliation: Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto; ; The Children's Aid Society;
authors.forename: Leo
authors.initials: L
authors.lastname: Levin
authors.affiliation: Child and Family Relations Center for Innovation and Excellence in Child and Family-Centered Care, The Hospital for Sick Children;
authors.forename: Karima
authors.initials: K
authors.lastname: Karmali
authors.affiliation: Department of Social Work, The Hospital for Sick Children and University of Toronto;
authors.forename: Barbara
authors.initials: B
authors.lastname: Neilson
authors.affiliation: Department of Social Work, The Hospital for Sick Children and University of Toronto;
authors.forename: Barbara
authors.initials: B
authors.lastname: Muskat
authors.affiliation: Family Medicine, The Hospital for Sick Children and Munk Centre for Global Studies, University of Toronto;
authors.forename: Gary
authors.initials: G
authors.lastname: Bloch
authors.affiliation: Department of Emergency Medicine, The Hospital for Sick Children and Munk Centre for Global Studies, University of Toronto;
authors.forename: Kevin
authors.initials: K
authors.lastname: Chan
authors.affiliation: Mothercraft, Toronto, Ontario.
authors.forename: Maureen
authors.initials: M
authors.lastname: McDonald
authors.affiliation: Toronto Public Health, Toronto, Ontario.
authors.forename: Sue
authors.initials: S
authors.lastname: Makin
authors.affiliation: Social Pediatrics, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto;
authors.forename: E Lee
authors.initials: EL
authors.lastname: Ford-Jones
keywords: Health care delivery; Paediatrics; Social determinants of health